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Updated: Feb 2, 2026

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Frailty predicts severe postoperative complications after elective colorectal surgery
Hirohisa Okabe1, Takayuki Ohsaki2, Katsuhiro Ogawa3
1Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan; Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Background:
We aim to clarify if frailty affects severe postoperative complications in elective colorectal surgery.
Methods:
Consecutive 269 colorectal cancer patients older than 65 years undergoing curative surgery were enrolled in this study. The relevance of the frailty and sarcopenia to postoperative outcome was assessed. Clinical frailty (CF) was defined as clinical frailty scale (CFS) ≥ 4. Sarcopenia was assessed by measuring skeletal muscle area using computed tomography.
Results:
Seventy-eight patients (29%) had CF and 159 patients (59%) had sarcopenia. CF was significantly associated with older age (P = 0.0008), postoperative severe complications (P = 0.001), and postoperative in-hospital stay (P < 0.0001), although sarcopenia was not. Logistic regression analysis revealed that low anterior resection and CF were independent predictors of severe postoperative complications (P = 0.038 and P = 0.001, respectively).
Conclusion:
CF, but not sarcopenia, is a robust predictor of severe postoperative complications in patients with colorectal cancer.
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