{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:14:20Z","timestamp":1778854460243,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the clinical utility and prognostic significance of sarcopenia classification based on the psoas major muscle volume index (PVI) in elderly patients with rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 428 patients aged \u2265\u200965\u2009years who underwent laparoscopic or robot\u2010assisted radical rectal cancer resection between 2014 and 2018. PVI was calculated by dividing the semi\u2010automatically measured psoas major muscle volume on three\u2010dimensional computed tomography (CT) by the cube of height (m\n                      <jats:sup>3<\/jats:sup>\n                      ). Sex\u2010specific PVI cutoff values for 5\u2010year overall survival (OS) were determined using time\u2010dependent receiver operating characteristic analysis. Associations between PVI, nutritional and inflammatory markers, conventional sarcopenia indices, and long\u2010term outcomes were investigated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PVI cut\u2010off values were \u2264\u200958.9\u2009cm\n                      <jats:sup>3<\/jats:sup>\n                      \/m\n                      <jats:sup>3<\/jats:sup>\n                      for males and \u2264\u200939.9\u2009cm\n                      <jats:sup>3<\/jats:sup>\n                      \/m\n                      <jats:sup>3<\/jats:sup>\n                      for females. Patients with low PVI had significantly worse nutritional and inflammatory profiles. The 5\u2010year OS (86.6% vs. 94.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), cancer\u2010specific survival (93.5% vs. 97.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and relapse\u2010free survival (76.2% vs. 85.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) were significantly lower in the low PVI group than in the normal\u2010high PVI group. Multivariate analysis identified low PVI (hazard ratio: 2.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012) and Prognostic Nutritional Index &lt;\u200940 as independent predictors of poor OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PVI\u2010based sarcopenia classification reflects nutritional and inflammatory status and enables effective prognostic stratification in elderly patients with rectal cancer. It may serve as a simple and objective tool for preoperative risk assessment, offering improved prognostic stratification compared with conventional CT\u2010based indices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70162","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T07:26:46Z","timestamp":1767684406000},"page":"770-778","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Value of Psoas Major Muscle Volume in Assessing Sarcopenia in Elderly Patients With Rectal Cancer"],"prefix":"10.1002","volume":"10","author":[{"given":"Gen","family":"Tsujio","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka Cancer Center  Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoichi","family":"Manabe","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Shizuoka 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