Body composition and outcome in patients undergoing resection of colorectal liver metastases

Background: Recent evidence suggests that depletion of skeletal muscle mass (sarcopenia) and an increased amount of intra-abdominal fat (central obesity) influence cancer statistics. This study investigated the impact of sarcopenia and central obesity on survival in patients undergoing liver resection for colorectal liver metastases (CLM). Methods: Diagnostic imaging from patients who had hepatic resection for CLM in one centre between 2001 and 2009, and who had assessable perioperative computed tomograms, was analysed retrospectively. Total cross-sectional areas of skeletal muscle and intra-abdominal fat, and their influence on outcome, were analysed. Results: Of the 196 patients included in the study, 38 (19.4 per cent) were classified as having sarcopenia. Five-year disease-free (15 per cent versus 28.5 per cent in patients without sarcopenia; P = 0.002) and overall (20 per cent versus 49.9 per cent respectively; P < 0.001) survival rates were lower for patients with sarcopenia at a median follow-up of 29 (range 1-97) months. Sarcopenia was an independent predictor of worse recurrence-free (hazard ratio (HR) 1.88, 95 per cent confidence interval 1.25 to 2.82; P = 0.002) and overall (HR 2.53, 1.60 to 4.01; P < 0.001) survival. Central obesity was associated with an increased risk of recurrence in men (P = 0.032), but not in women (P = 0.712). Conclusion: Sarcopenia has a negative impact on cancer outcomes following resection of CLM.