Computed tomography-assessed presarcopenia and clinical outcomes after laparoscopic surgery for rectal cancer

Purpose: Previous studies have reported that presarcopenia negatively affects rectal cancer treatment. However, most studies have an-alyzed patients including majority of open surgery, and the association between presarcopenia and clinical outcomes after laparoscop-ic rectal cancer surgery remains unclear. This study aimed to evaluate the impact of presarcopenia on the clinical and oncological out-comes after laparoscopic rectal cancer surgery. Methods: Three hundred and one patients undergoing laparoscopic rectal cancer surgery between December 2009 and May 2016 were enrolled. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lum-bar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate presarcopenia.Results: Presarcopenia was more common in older (>= 70 years, P = 0.008) or female patients (P = 0.045). Patients with presarcopenia had decreased skeletal muscle area (P < 0.001), lower hemoglobin level (P = 0.034), longer time to first flatus (P < 0.001), and more fre-quent surgical site infection (P = 0.001). However, survival rates were not significantly different between those with and without pre-sarcopenia.Conclusion: Computed tomography-assessed presarcopenia was associated with delayed functional recovery and increased surgical site infection, although it was not revealed as a prognostic factor for oncological outcomes.