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Skeletal Muscle Depletion is Associated with Severe Postoperative Complications in Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

An Erratum to this article was published on 20 March 2015

Abstract

Background

In patients undergoing colorectal cancer surgery, skeletal muscle depletion (sarcopenia) is associated with impaired postoperative recovery and decreased survival. This study aimed to determine whether skeletal muscle depletion can predict postoperative complications for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for peritoneal carcinomatosis of colorectal cancer.

Methods

All consecutive patients with an available preoperative computed tomography (CT) scan who underwent CRS-HIPEC for peritoneal carcinomatosis of colorectal cancer in two centers were analyzed. Skeletal muscle mass was determined using the L3 muscle index on the preoperative CT scan. The cutoff values defined by Prado et al. were used to classify the patients as sarcopenic or nonsarcopenic.

Results

Of the study’s 206 patients, 90 (43.7 %) were classified as sarcopenic. The sarcopenic patients underwent significantly more reoperations than the nonsarcopenic patients (25.6 vs. 12.1 %; p = 0.012). The mean L3 muscle index was significantly lower for the patients who experienced severe postoperative complications than for the patients without severe postoperative complications (85.6 vs. 110.2 cm2/m2; p = 0.008). In a multivariable logistic regression model, L3 muscle index was the only parameter independently associated with the risk of severe postoperative complications (odds ratio 0.93; 95 % confidence interval 0.87–0.99; p = 0.018).

Conclusion

Skeletal muscle mass depletion, assessed using CT-based muscle mass measurements, is associated with an increased risk of severe postoperative complications in patients undergoing CRS-HIPEC for colorectal peritoneal carcinomatosis and could therefore be used in preoperative risk assessment.

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Authors and Affiliations

  1. Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands

    Jeroen L. A. van Vugt MD, Hidde J. Braam MD, Asra Vestering BSc, Marinus J. Wiezer MD, PhD, Bert van Ramshorst MD, PhD & Djamila Boerma MD, PhD

  2. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands

    Thijs R. van Oudheusden MD & Ignace H. J. T. de Hingh MD, PhD

  3. Department of Radiology, St Antonius Hospital, Nieuwegein, The Netherlands

    Thomas L. Bollen MD, PhD

Authors
  1. Jeroen L. A. van Vugt MD
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  2. Hidde J. Braam MD
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  3. Thijs R. van Oudheusden MD
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  4. Asra Vestering BSc
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  5. Thomas L. Bollen MD, PhD
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  6. Marinus J. Wiezer MD, PhD
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  7. Ignace H. J. T. de Hingh MD, PhD
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  8. Bert van Ramshorst MD, PhD
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  9. Djamila Boerma MD, PhD
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Corresponding author

Correspondence to Djamila Boerma MD, PhD.

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van Vugt, J.L.A., Braam, H.J., van Oudheusden, T.R. et al. Skeletal Muscle Depletion is Associated with Severe Postoperative Complications in Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Cancer. Ann Surg Oncol 22, 3625–3631 (2015). https://doi.org/10.1245/s10434-015-4429-z

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  • DOI: https://doi.org/10.1245/s10434-015-4429-z

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