{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:24:58Z","timestamp":1767677098117,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gastrointestinal Disorders"],"abstract":"<jats:p>Background: Colorectal cancer (CRC) surgery is associated with high rates of postoperative morbimortality. Sarcopenia has been identified as an independent predictor of these surgical outcomes. Methods: A sample of 272 patients who underwent CRC surgery between January 2005 and May 2010 at Braga Hospital, was selected. Sarcopenia was defined by the skeletal muscle mass index, measured by preoperative computed tomography (CT), at L3 level, using ImageJ\u00ae software. Associations between sarcopenia and qualitative variables were analyzed by Chi-Square Test (\u03c72) or Fisher\u2019s Exact Test and, for quantitative variables, by Mann-Whitney Test. A multivariate logistic regression was performed to assess if sarcopenia was an independent predictor of major morbidity. The overall and recurrence-free survivals were analyzed by Kaplan-Meier method and multivariate Cox regression was performed for recurrence-free survival. Results: The prevalence of sarcopenia was 19.1%. Sarcopenia was associated with male gender, no CRC family history and colon tumour (p &lt; 0.001, p = 0.029 and p = 0.017, respectively). The presence of sarcopenia was associated with postoperative morbidity Clavien\u2013Dindo classification (p = 0.003), and sarcopenia was an independent predictor for major complications (grade \u2265 III) (p = 0.003). Conclusions: The evaluation of sarcopenia in patients undergoing CRC surgical resection allows to predict a higher probability of major postoperative morbimortality.<\/jats:p>","DOI":"10.3390\/gidisord2020010","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T11:42:14Z","timestamp":1587728534000},"page":"107-117","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sarcopenia as a Risk Factor of Morbimortality in Colorectal Cancer Surgery"],"prefix":"10.3390","volume":"2","author":[{"given":"Mariana","family":"Pereira","sequence":"first","affiliation":[{"name":"School of Medicine, University of Minho, 4710-070 Braga, Portugal"}]},{"given":"Ana","family":"Pereira","sequence":"additional","affiliation":[{"name":"General Surgery Resident, Hospital de Braga, 4710-243 Braga, Portugal"}]},{"given":"Patr\u00edcia","family":"Silva","sequence":"additional","affiliation":[{"name":"General Surgery Resident, Hospital de Braga, 4710-243 Braga, Portugal"}]},{"given":"Catarina","family":"Costa","sequence":"additional","affiliation":[{"name":"Imagiology Department, Braga Hospital, 4710-243 Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3526-3199","authenticated-orcid":false,"given":"Sandra F.","family":"Martins","sequence":"additional","affiliation":[{"name":"Coloproctology Unit, Department of General Surgery, Hospital de Braga, 4710-243 Braga, Portugal"},{"name":"Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, 4710-070 Braga, Portugal"},{"name":"Life and Health Sciences Research Institute (ICVS)\/3B\u2019s-PT Government Associate Laboratory, Braga\/Guimar\u00e3es, 4710-070 Braga, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global cancer statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer statistics","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4667","DOI":"10.18203\/2320-6012.ijrms20174914","article-title":"Colorectal cancer: A review","volume":"5","year":"2017","journal-title":"Int. J. Res. Med. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis","volume":"39","author":"Baeyens","year":"2010","journal-title":"Age Ageing"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jocd.2015.04.012","article-title":"The epidemiology of sarcopenia","volume":"18","author":"Dodds","year":"2016","journal-title":"J. Clin. Densitom."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.1093\/annonc\/mds236","article-title":"Esmo consensus guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making","volume":"23","author":"Schmoll","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1002\/(SICI)1097-0142(20000401)88:7<1739::AID-CNCR30>3.0.CO;2-T","article-title":"American Joint Committee on Cancer prognostic factors consensus conference","volume":"88","author":"Compton","year":"2000","journal-title":"Cancer"},{"key":"ref_8","first-page":"9","article-title":"Diagn\u00f3stico, estadiamento e tratamento do adenocarcinoma do c\u00f3lon e do reto","volume":"1","author":"George","year":"2013","journal-title":"Norma Dire\u00e7\u00e3o Geral Sa\u00fade"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jgo.2015.08.005","article-title":"Prevalence of sarcopenia in older patients with colorectal cancer","volume":"6","author":"Broughman","year":"2015","journal-title":"J. Geriatr. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2333","DOI":"10.1152\/japplphysiol.00744.2004","article-title":"Total body skeletal muscle and adipose tissue volumes: Estimation from a single abdominal cross-sectional image","volume":"97","author":"Shen","year":"2004","journal-title":"J. Appl. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1139\/H08-075","article-title":"A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care","volume":"33","author":"Mourtzakis","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ejso.2014.10.056","article-title":"The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: A systematic review","volume":"41","author":"Malietzis","year":"2015","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1038\/bjc.2012.350","article-title":"Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery","volume":"107","author":"Lieffers","year":"2012","journal-title":"Br. J. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"O20","DOI":"10.1111\/codi.12805","article-title":"Simple psoas cross-sectional area measurement is a quick and easy method to assess sarcopenia and predicts major surgical complications","volume":"17","author":"Jones","year":"2015","journal-title":"Colorectal Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1007\/s00384-016-2538-1","article-title":"Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer","volume":"31","author":"Boer","year":"2016","journal-title":"Int. J. Colorectal Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.1245\/s10434-014-4281-6","article-title":"Sarcopenia is a negative prognostic factor after curative resection of colorectal cancer","volume":"22","author":"Miyamoto","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1754-9493-4-5","article-title":"Complications in colorectal surgery: Risk factors and preventive strategies","volume":"4","author":"Kirchhoff","year":"2010","journal-title":"Patient Saf. Surg."},{"key":"ref_18","first-page":"32","article-title":"Determinants of long-term survival after major surgery and the adverse effect of postoperative complications","volume":"123","author":"Khuri","year":"2005","journal-title":"Trans. Meet Am. Surg Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s00595-017-1564-0","article-title":"Sarcopenia is an independent predictor of complications after colorectal cancer surgery","volume":"48","author":"Nakanishi","year":"2017","journal-title":"Surg. Today"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1245\/s10434-017-5829-z","article-title":"Prognostic value of computed tomography: Measured parameters of body composition in primary operable gastrointestinal cancers","volume":"24","author":"Black","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/SLA.0000000000000628","article-title":"Functional compromise reflected by sarcopenia, frailty, and nutritional depletion predicts adverse postoperative outcome after colorectal cancer surgery","volume":"261","author":"Reisinger","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1177\/0148607115604149","article-title":"Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ","volume":"40","author":"Haus","year":"2016","journal-title":"J. Parenter. Enteral Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1177\/0148607114550189","article-title":"Lean tissue imaging","volume":"38","author":"Prado","year":"2014","journal-title":"J. Parenter Enter. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S1470-2045(08)70153-0","article-title":"Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study","volume":"9","author":"Prado","year":"2008","journal-title":"Lancet Oncol."}],"container-title":["Gastrointestinal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2624-5647\/2\/2\/10\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:23:41Z","timestamp":1760361821000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2624-5647\/2\/2\/10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,24]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["gidisord2020010"],"URL":"https:\/\/doi.org\/10.3390\/gidisord2020010","relation":{},"ISSN":["2624-5647"],"issn-type":[{"type":"electronic","value":"2624-5647"}],"subject":[],"published":{"date-parts":[[2020,4,24]]}}}