Page 91 - Risk quantification and modification in older patients with colorectal cancer

Physical performance and poor surgical outcomes
Introduction
Colorectal cancer (CRC) is predominantly an illness of older patients, with more than 50% of all new patients aged 70 years or older.1 In this heterogeneous group of older patients, there is a need for markers associated with outcome to guide individual decision making for the treatment of CRC.
In relatively younger colorectal cancer patients (mean age 58-71) low skeletal muscle mass and muscle density have been associated with postoperative complications and longer hospital stay after cancer surgery2-7 and increased risk of chemotoxicity.8 Therefore, skeletal muscle mass or muscle density has the potential to predict adverse outcomes and possibly guide individual patient- centred decision making.
It remains unclear whether low skeletal muscle mass and muscle density are associated with poor surgical outcome in older patients. Previous studies were performed in groups with heterogeneous age and stage composition hindering interpretation of the observed associations between skeletal muscle mass and quality and outcomes for older patients. Furthermore, it is important to assess physical performance when assessing skeletal muscle mass.5,9 This is supported by the recently updated guidelines of the European Working Group on Sarcopenia in Older People (EWGSOP).10
This study aimed to investigate the association between skeletal muscle mass and density and physical performance with postoperative complications as well as Overal Survival (OS) in older patients undergoing elective surgery for non- metastatic CRC.
Patients and methods
Study population
All consecutive patients aged ≥ 70 years with colorectal surgery between January 1st 2014 and December 30th 2016 from a large teaching hospital in the Netherlands (Hagaziekenhuis) were identified from the prospectively collected Dutch Colorectal Audit database (DCRA).11 This hospital provides geriatric-oncological
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