{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:40:39Z","timestamp":1780760439903,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"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":["Colorectal Disease"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia is defined by a paucity of skeletal muscle mass, strength and function. The relationship between pre\u2010operative sarcopenia and poor surgical outcomes in colorectal cancer (CRC) is well described. This study investigates the novel concept of \u2018sarcopenia kinetics\u2019\u2014the change in sarcopenia status over time. Specifically, it aims to assess the association between sarcopenia kinetics and surgical outcomes in patients who have undergone CRC resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An observational cohort study of consecutive patients who underwent surgery between 2016 and 2020 at a tertiary referral centre in Sydney, Australia, was performed. Pre\u2010operative and post\u2010operative CT scans were reviewed to calculate pre\u2010operative and post\u2010operative skeletal muscle indices (SMI). Sarcopenia was defined by the lowest quartile of sex\u2010specific pre\u2010operative SMI. Survival analysis was performed on the basis of change in SMI and sarcopenia classification, with primary end points of overall survival (OS) and disease\u2010free survival (DFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 545 patients underwent surgery for CRC during the study period. Of these patients, 186 met inclusion criteria, having accessible pre\u2010operative and post\u2010operative CT scans. The study population was 36% female, with a mean age of 76.0\u2009years (SD 11.7). Over a 4.4\u2010year median follow\u2010up, 55 (28%) developed recurrence, and 85 (43%) died, with a 1\u2010year OS of 87.1% (95% CI 81.4\u201391.2), 5\u2010year OS of 58.6% (95% CI 50.8\u201365.6) and 5\u2010year DFS of 50.4% (95% CI 42.8\u201357.5). Post\u2010operative decrease in SMI was associated with poorer OS (HR 1.81 [95% CI 1.16\u20132.82],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). Patients who became sarcopenic post\u2010operatively demonstrated the poorest OS (HR 2.36 [95% CI 1.22\u20134.58],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) and DFS (HR 2.61 [95% CI 1.42\u20134.80],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) when compared with patients who were never sarcopenic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sarcopenia kinetics, on the basis of SMI change and change in sarcopenia status, are associated with OS and DFS in patients undergoing CRC surgery. Decreasing SMI is associated with poorer OS, while patients who become sarcopenic post\u2010operatively have the poorest outcomes. Sarcopenia kinetics have utility as a prognostic indicator and may represent a modifiable risk factor warranting further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70258","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T07:46:00Z","timestamp":1759995960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sarcopenia kinetics and colorectal cancer outcomes: Post\u2010operative development of sarcopenia is a poor prognostic indicator of survival following colorectal cancer surgery"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1740-1236","authenticated-orcid":false,"given":"Nicholas","family":"Kesby","sequence":"first","affiliation":[{"name":"Colorectal Surgery Unit Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Chia","sequence":"additional","affiliation":[{"name":"Concord Institute of Academic Surgery Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology Concord Hospital  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre H.","family":"Chapuis","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Concord Hospital  Concord New South Wales Australia"},{"name":"Concord Institute of Academic Surgery Concord Hospital  Concord New South Wales Australia"},{"name":"Concord Clinical School, Clinical Sciences Building Concord Hospital, University of Sydney  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kheng\u2010Seong","family":"Ng","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Concord Hospital  Concord New South Wales Australia"},{"name":"Concord Institute of Academic Surgery Concord Hospital  Concord New South Wales Australia"},{"name":"Concord Clinical School, Clinical Sciences Building Concord Hospital, University of Sydney  Concord New South Wales 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