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结直肠癌手术后力量、步行辅助、从椅子上起身、爬楼梯及跌倒评分对术后临床结局的影响:一项回顾性研究

Effects of the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls score on postoperative clinical outcomes following colorectal cancer surgery: a retrospective study.

作者信息

Kim Young Jae, Bae Sung Uk, Kim Kyeong Eui, Jeong Woon Kyung, Baek Seong Kyu

机构信息

Department of Medicine, Keimyung University School of Medicine, Daegu, Korea.

Department of Surgery, School of Medicine, Keimyung University and Dongsan Medical Center, Daegu, Korea.

出版信息

Eur J Clin Nutr. 2025 Apr;79(4):358-364. doi: 10.1038/s41430-024-01509-6. Epub 2024 Oct 24.

Abstract

BACKGROUND/OBJECTIVES: Sarcopenia has known negative effects on clinical and oncological outcomes in patients with colorectal cancer (CRC). The use of the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire to determine the effects of sarcopenia on postoperative complications of CRC has not been reported to date. Therefore, this study aimed to investigate the relationship of SARC-F score with clinicopathologic outcomes after CRC surgery.

SUBJECTS/METHODS: We retrospectively included 285 patients who completed SARC-F questionnaires before CRC surgery between July 2019 and March 2022. Patients with an SARC-F score ≥4 (total score: 10) were classified in the high SARC-F group.

RESULTS

Overall, 34 (11.9%) patients had high SARC-F scores. These patients were older (76.9 ± 8.5 vs. 64.5 ± 11.4 years, p < 0.001) and had a higher preoperative CRP (2.5 ± 3.9 vs. 0.8 ± 1.6 mg/L, p = 0.019), lower body mass index (21.7 ± 3.4 vs. 24.0 ± 3.8 kg/m, p = 0.001), and higher pan-immune-inflammation value (632.3 ± 615.5 vs. 388.9 ± 413.8, p = 0.031). More postoperative complications were noted in the high SARC-F group than in the low SARC-F group (58.8% vs. 35.6%, p = 0.009). High SARC-F scores were significantly associated with higher nodal stage, higher number of harvested lymph nodes, and larger tumor size. Univariate and multivariate analyses revealed high SARC-F score and operation time as independent risk factors associated with postoperative complications (odds ratio, 2.212/1.922; 95% confidence interval, 1.021-4.792/1.163-3.175; p = 0.044/0.011, respectively).

CONCLUSIONS

Preoperative SARC-F score was an independent risk factor associated with postoperative complications following colorectal cancer surgery.

摘要

背景/目的:肌肉减少症对结直肠癌(CRC)患者的临床和肿瘤学结局具有已知的负面影响。迄今为止,尚未有研究报道使用“力量、行走辅助、从椅子上起身、爬楼梯和跌倒(SARC-F)”问卷来确定肌肉减少症对CRC术后并发症的影响。因此,本研究旨在探讨SARC-F评分与CRC手术后临床病理结局之间的关系。

对象/方法:我们回顾性纳入了2019年7月至2022年3月期间在CRC手术前完成SARC-F问卷的285例患者。SARC-F评分≥4分(总分:10分)的患者被归类为高SARC-F组。

结果

总体而言,34例(11.9%)患者的SARC-F评分较高。这些患者年龄较大(76.9±8.5岁 vs. 64.5±11.4岁,p<0.001),术前CRP较高(2.5±3.9 vs. 0.8±1.6mg/L,p = 0.019),体重指数较低(21.7±3.4 vs. 24.0±3.8kg/m²,p = 0.001),全免疫炎症值较高(632.3±615.5 vs. 388.9±413.8,p = 0.031)。高SARC-F组的术后并发症比低SARC-F组更多(58.8% vs. 35.6%,p = 0.009)。高SARC-F评分与更高的淋巴结分期、更多的收获淋巴结数量和更大的肿瘤大小显著相关。单因素和多因素分析显示,高SARC-F评分和手术时间是与术后并发症相关的独立危险因素(比值比,2.212/1.922;95%置信区间,1.021 - 4.792/1.163 - 3.175;p分别为0.044/0.011)。

结论

术前SARC-F评分是结直肠癌手术后与术后并发症相关的独立危险因素。

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