Preoperative body composition metrics as predictors for outcomes in colorectal cancer surgeries

Surgical treatment of colorectal cancer (CRC) carries risks of complications such as hernia, obstruction, and infections. Recent studies have assessed the effect of some preoperative body composition (BC) measures on postoperative outcomes in CRC patients. However, the available data is scattered and inconsistent for different BC metrics and complications. We aim to evaluate the predictive value of all BC measures reported in the literature regarding CRC surgery outcomes.

This systematic review and meta-analysis followed PRISMA guidelines, searching PubMed, Scopus, Web of Science, and Embase from inception to January 2024. We included original studies that reported preoperative BC parameters and postoperative outcomes in CRC patients. Relevant data were extracted from the included studies. Our analysis involved calculating odds ratios and corresponding 95% confidence intervals.

We found 19 eligible studies with a total population of 7416 patients. We found that, unlike subcutaneous fat area, higher visceral fat area values were associated with higher rates of postoperative complications (MD = 31.91, 95% CI 21.15-42.67). Sarcopenia was associated with higher rates of postoperative total complications (RR = 1.24, 95% CI 1.02-1.51), ileus (RR = 1.40, 95% CI 1.01-1.95), and readmission (RR = 2.18, 95% CI 1.35-3.52); but not postoperative infection, leak, obstruction, and hospital length of stay.

Preoperative BC metrics may be useful predictors of some CRC surgery outcomes and complications. However further studies with more homogenous methods are needed for integrating these values into routine pre-operation assessment.