Sarcopenia and myosteatosis in colorectal cancer
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital, Auditorium 3
Topic of the dissertation
Sarcopenia and myosteatosis in colorectal cancer
Doctoral candidate
Licentiate of Medicine Raila Aro
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Medical research center Oulu
Subject of study
medicine
Opponent
docent Jyrki Kössi, Päijät-Häme Central Hospital
Custos
professor Juha Saarnio, Oulu University, Oulu University Hospital
Sarcopenia and myosteatosis in colorectal cancer
Sarcopenia (loss of muscle mass, function and strength) and myosteatosis (fat infiltration in muscle) are frequent among colorectal cancer (CRC) patients and may have negative impact on the risk of postoperative complications and survival. Due to scarce previous research, the mechanisms and factors developing these conditions are not fully understood in CRC patients. Oral nutritional supplements (ONS) have been suggested to reduce complication rates, but evidence to support their use is scarce.
The aim of this study was to define the prevalence of myosteatosis and sarcopenia in CRC patients and to evaluate their effects on morbidity, mortality and survival. Other aims were to analyze the association of sarcopenia and myosteatosis with systemic inflammation and to establish skeletal muscle density/skeletal muscle index (SMD/SMI) cut-off values for CRC patients. Another aim was to evaluate the role of perioperative ONS in colon cancer patients’ postoperative outcomes.
Study I was a retrospective cohort of 348 CRC patients. In study I, the rate of sarcopenia was 60% and myosteatosis 30%. Sarcopenia was associated with pneumonia and both myosteatosis and sarcopenia were associated with lower rate of patient discharge to home. Myosteatotic stage I-III patients had worse 5-year overall survival (OS). Study II was a retrospective cohort of 222 CRC patients that found myosteatosis and sarcopenia to associate with elevated neutrophil-to-lymphocyte ratio (NLR). Myosteatosis was associated with the serrated CRC subtype. Study III was a retrospective cohort study of 927 CRC patients that revealed low SMD to independently associate with worse cancer-specific survival (CSS) and OS in women. Low SMD associated with higher American Society of Anesthesiologist (ASA) score and systemic inflammation. Study IV presented a randomized controlled multicenter study (Peri-Nutri Trial) to evaluate whether perioperative ONS used two weeks prior to surgery and 10 days after surgery can decrease 30-day postoperative complication rates.
To conclude, sarcopenia and myosteatosis are frequently found in patients with CRC. They associate with worse short- and long-term results in CRC patients. Muscle abnormalities are not solely caused by cancer but are also linked to age and increased morbidity.
The aim of this study was to define the prevalence of myosteatosis and sarcopenia in CRC patients and to evaluate their effects on morbidity, mortality and survival. Other aims were to analyze the association of sarcopenia and myosteatosis with systemic inflammation and to establish skeletal muscle density/skeletal muscle index (SMD/SMI) cut-off values for CRC patients. Another aim was to evaluate the role of perioperative ONS in colon cancer patients’ postoperative outcomes.
Study I was a retrospective cohort of 348 CRC patients. In study I, the rate of sarcopenia was 60% and myosteatosis 30%. Sarcopenia was associated with pneumonia and both myosteatosis and sarcopenia were associated with lower rate of patient discharge to home. Myosteatotic stage I-III patients had worse 5-year overall survival (OS). Study II was a retrospective cohort of 222 CRC patients that found myosteatosis and sarcopenia to associate with elevated neutrophil-to-lymphocyte ratio (NLR). Myosteatosis was associated with the serrated CRC subtype. Study III was a retrospective cohort study of 927 CRC patients that revealed low SMD to independently associate with worse cancer-specific survival (CSS) and OS in women. Low SMD associated with higher American Society of Anesthesiologist (ASA) score and systemic inflammation. Study IV presented a randomized controlled multicenter study (Peri-Nutri Trial) to evaluate whether perioperative ONS used two weeks prior to surgery and 10 days after surgery can decrease 30-day postoperative complication rates.
To conclude, sarcopenia and myosteatosis are frequently found in patients with CRC. They associate with worse short- and long-term results in CRC patients. Muscle abnormalities are not solely caused by cancer but are also linked to age and increased morbidity.
Last updated: 15.8.2025