Sarcopenic Obesity Promotes Recurrence in Patients Undergoing Resection for Colorectal Liver Metastases (CRLM)

Area of Science:

• Oncology
• Surgical Oncology
• Metabolic Research

Background:

• Sarcopenia predicts poor outcomes in colorectal liver metastases (CRLM) resection.
• Obesity combined with sarcopenia, termed sarcopenic obesity (SO), presents a metabolic burden that may accelerate malignancy.
• Understanding the prognostic impact of SO in CRLM patients is crucial.

Purpose of the Study:

• To compare the prognostic significance of sarcopenia and sarcopenic obesity (SO) in patients undergoing CRLM resection.
• To evaluate the predictive value of SO and sarcopenia against established prognostic parameters for postoperative outcomes.

Main Methods:

• Sarcopenia was defined using skeletal muscle index (SMI) with sex-specific L3 vertebral cutoffs on preoperative CT scans.
• Sarcopenic obesity (SO) was identified in sarcopenic patients with obesity, assessed by preoperative CT fat percentage.
• Prognostic parameters including KRAS status, TNM classification, and inflammatory markers were analyzed against SMI and SO.

Main Results:

• Sarcopenic patients had a threefold higher risk of postoperative death (p=0.04).
• Sarcopenic obesity (SO) increased this risk fivefold (p=0.01) compared to non-sarcopenic individuals.
• SO and KRAS positivity independently predicted disease-free survival (p=0.038 and p=0.041, respectively); combined, they increased mortality risk sevenfold (p=0.03).

Conclusions:

• Sarcopenic obesity (SO) is a significant independent prognostic factor in CRLM resection.
• Integrating muscle wasting data (sarcopenia, SO) with mutational status (e.g., KRAS) enhances prognostic accuracy.
• A combined approach facilitates personalized treatment strategies for CRLM patients.