Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 9 (1), 53-59

Sarcopenia Is Negatively Associated With Long-Term Outcomes in Locally Advanced Rectal Cancer


Sarcopenia Is Negatively Associated With Long-Term Outcomes in Locally Advanced Rectal Cancer

Moon Hyung Choi et al. J Cachexia Sarcopenia Muscle.


Background: The association of sarcopenia and visceral obesity to treatment outcome is not clear for locally advanced rectal cancer. This study evaluates the influence of skeletal muscle and visceral fat on short-term and long-term outcomes in locally advanced rectal cancer patients treated with neoadjuvant chemoradiation therapy followed by curative resection.

Methods: A total of 188 patients with locally advanced cancer were included between January 2009 and December 2013. Neoadjuvant chemoradiotherapy was followed by curative resection. Sarcopenia and visceral obesity were identified in initial staging CT by measuring the muscle and visceral fat area at the third lumbar vertebra level.

Results: Among the 188 included patients, 74 (39.4%) patients were sarcopenic and 97 (51.6%) patients were viscerally obese. Sarcopenia and high levels of preoperative carcinoembryonic antigen were significant prognostic factors for overall survival (P = 0.013, 0.014, respectively) in the Cox regression multivariate analysis. Visceral obesity was not associated with overall survival; however, it did tend to shorten disease-free survival (P = 0.079).

Conclusions: Sarcopenia is negatively associated with overall survival in locally advanced rectal cancer patients who underwent neoadjuvant chemoradiation therapy and curative resection. Visceral obesity tended to shorten disease-free survival. Future studies should be directed to optimize patient conditions according to body composition status.

Keywords: Prognosis; Rectal cancer; Sarcopenia; Visceral obesity.


Figure 1
Figure 1
Overall survival (OS) according to sarcopenia.
Figure 2
Figure 2
Overall survival (OS) according to visceral obesity.
Figure 3
Figure 3
Disease‐free survival (DFS) according to sarcopenia.
Figure 4
Figure 4
Disease‐free survival (DFS) according to visceral obesity.

Similar articles

See all similar articles

Cited by 13 PubMed Central articles

See all "Cited by" articles


    1. Prado CM, Lieffers JR, McCargar LJ, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population‐based study. Lancet Oncol 2008;9:629–635. - PubMed
    1. Bardou M, Barkun AN, Martel M. Obesity and colorectal cancer. Gut 2013;62:933–947. - PubMed
    1. Gibson DJ, Burden ST, Strauss BJ, Todd C, Lal S. The role of computed tomography in evaluating body composition and the influence of reduced muscle mass on clinical outcome in abdominal malignancy: a systematic review. Eur J Clin Nutr 2015;69:1079–1086. - PubMed
    1. Levolger S, van Vugt JL, de Bruin RW, IJzermans JN. Systematic review of sarcopenia in patients operated on for gastrointestinal and hepatopancreatobiliary malignancies. Br J Surg 2015;102:1448–1458. - PubMed
    1. van Vugt JL, Braam HJ, van Oudheusden TR, et al. Skeletal muscle depletion is associated with severe postoperative complications in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 2015;22:3625–3631. - PubMed

Publication types