{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:32:20Z","timestamp":1783074740978,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The association between perioperative changes in the skeletal muscle index (SMI) and colorectal cancer (CRC) outcomes remains unclear. We aim to explore perioperative change patterns of SMI and evaluate their effects on long\u2010term outcomes in CRC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included Stage I\u2013III CRC patients who underwent curative resection between 2012 and 2019. SMI at the third lumbar vertebra level was calculated using computed tomography scans. Optimal cut\u2010off values for SMI were defined separately for males and females and classified as high or low preoperatively and at 3, 6, 9 and 12\u2009months postoperatively. SMI status was further categorized into different perioperative SMI change patterns: high<jats:sub>pre<\/jats:sub>\u2013high<jats:sub>post<\/jats:sub>, high<jats:sub>pre<\/jats:sub>\u2013low<jats:sub>post<\/jats:sub>, low<jats:sub>pre<\/jats:sub>\u2013high<jats:sub>post<\/jats:sub> and low<jats:sub>pre<\/jats:sub>\u2013low<jats:sub>post<\/jats:sub>. The association with recurrence\u2010free survival (RFS) and overall survival (OS) was examined using Cox proportional hazards models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2222 patients (median [interquartile range] age, 60.00 [51.00\u201368.00] years; 1302 (58.60%) men; 222 (9.99%) with preoperative low SMI) were evaluated. During a median follow\u2010up of 60\u2009months, 375 patients (16.88%) died, and 617 patients (27.77%) experienced a recurrence. Multivariate Cox model analysis showed that, compared to patients with high<jats:sub>pre<\/jats:sub>\u2013high<jats:sub>post<\/jats:sub>, those with high<jats:sub>pre<\/jats:sub>\u2013low<jats:sub>post<\/jats:sub> (HR\u2009=\u20093.32, 95% CI: 1.60\u20136.51; HR\u2009=\u20092.54, 95% CI: 1.03\u20136.26; HR\u2009=\u20092.93, 95% CI: 1.19\u20137.19, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) had significantly worse RFS and OS (HR\u2009=\u20094.07, 95% CI: 1.55\u201310.69; HR\u2009=\u20094.78, 95% CI: 1.40\u201316.29; HR\u2009=\u20099.69, 95% CI: 2.53\u201337.05, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), at postoperative 6, 9 and 12\u2009months, respectively. Patients with low<jats:sub>pre<\/jats:sub>\u2013low<jats:sub>post<\/jats:sub> were an independent prognostic factor for worse OS at postoperative 12\u2009months (HR\u2009=\u20093.20, 95% CI: 1.06\u20139.71, <jats:italic>p<\/jats:italic>\u2009=\u20090.040). Patients with low<jats:sub>pre<\/jats:sub>\u2013high<jats:sub>post<\/jats:sub> had similar risk of RFS compared to those with high<jats:sub>pre<\/jats:sub>\u2013high<jats:sub>post<\/jats:sub> at postoperative 3, 6 and 12\u2009months (HR\u2009=\u20091.49, 95% CI: 0.75\u20132.98; HR\u2009=\u20091.05, 95% CI: 0.45\u20132.43; HR\u2009=\u20091.36, 95% CI: 0.31\u20136.06, all <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05) and similar risk of OS at postoperative 3, 6, 9 and 12\u2009months (all <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with a high preoperative SMI that decline postoperatively have poor RFS and OS. Consistently low SMI also correlates with worse OS. Patients with low SMI but increased after resection are not an indicator of better prognosis. Routine measurement of postoperative, rather than preoperative, SMI is warranted. Patients with low SMI are at an increased risk for recurrence and death, especially within the first year after surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13594","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T09:29:34Z","timestamp":1727947774000},"page":"2519-2535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Perioperative Skeletal Muscle Index Change With Outcome in Colorectal Cancer Patients"],"prefix":"10.1002","volume":"15","author":[{"given":"Zhenhui","family":"Li","sequence":"first","affiliation":[{"name":"Guangdong Cardiovascular Institute Guangdong Provincial People's Hospital, Guangdong Academy of Sciences  Guangzhou China"},{"name":"Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application  Guangzhou China"},{"name":"Department of Radiology The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghong","family":"Yan","sequence":"additional","affiliation":[{"name":"Yunnan Provincial Key Laboratory of Public Health and Biosafety Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmei","family":"Liu","sequence":"additional","affiliation":[{"name":"Yunnan Provincial Key Laboratory of Public Health and Biosafety Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center  Kunming 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