The impact of acute skeletal muscle loss after gastrointestinal cancer surgery on physical function

PM R. 2023 Feb;15(2):184-191. doi: 10.1002/pmrj.12774. Epub 2022 Feb 25.

Abstract

Introduction: Significant skeletal muscle loss occurs commonly after cancer surgery; however, the impact of postoperative acute skeletal muscle loss on physical function remains poorly understood.

Objective: To determine the impact of surgery-associated acute skeletal muscle wasting on physical function in the early postoperative period in patients with gastrointestinal cancer.

Design: A single-center retrospective observational study.

Setting: General hospital.

Patients: Hospitalized patients with gastrointestinal cancer who were admitted for surgery.

Intervention: Not applicable.

Main outcome measures: The main outcome was the partial correlation between postoperative changes in skeletal muscle index (SMI) and physical function such as handgrip strength, gait speed, and 6-minute walk test.

Results: A total of 69 patients (41 male and 28 female) with a mean age of 70.5 years were included. SMI was significantly correlated with physical function, such as handgrip strength (r = 0.757, p < .001), maximum gait speed (r = 0.318, p = .008), and 6-minute walk test (r = 0.365, p = .002) before surgery. In contrast, partial correlation analysis between the absolute changes in SMI and physical function after controlling for SMI and each physical function before surgery showed no significant correlation. Multivariable linear regression analyses also showed that postoperative change in SMI was not significantly associated with the postoperative change in physical function but it was associated with the length of stay after surgery, SMI at admission, and absolute change in body fat percentage.

Conclusions: The absolute change in SMI during the early postoperative period was not linearly correlated with the degree of decline in physical function. Further studies are necessary to investigate the effects of the respective changes in skeletal muscle mass and physical function on clinical outcomes.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Female
  • Gastrointestinal Neoplasms* / surgery
  • Hand Strength / physiology
  • Hospitalization
  • Humans
  • Male
  • Muscle, Skeletal
  • Retrospective Studies
  • Sarcopenia* / diagnosis
  • Sarcopenia* / etiology