Preoperative skeletal muscle density measured as an assessment of sarcopenia is correlated with postoperative complications in patients undergoing highly invasive surgery for upper abdominal cancer.

PURPOSE

Sarcopenia is characterized by loss of skeletal muscle mass, strength, and physical ability and is a well-established predictor of postoperative complications. However, the optimal method for preoperative assessment remains controversial. This study evaluated preoperative skeletal muscle density using computed tomography as a surrogate marker for sarcopenia to predict postoperative complications in patients undergoing highly invasive surgery for upper abdominal cancer.

METHODS

We examined 46 cases (esophagectomy, n = 33; pancreaticoduodenectomy, n = 13). We examined the relationship between clinical parameters and indicators of physical performance (peak load, six-minute walking test) and analyzed the impact of preoperative skeletal muscle density on postoperative complications.

RESULTS

Muscle density was significantly associated with physical performance in both parameters (peak load, p = 0.0007; six-minute walking test, p = 0.0001). The optimal cutoff value of muscle density for physical performance was 31.4 HU, with a sensitivity of 83.3% and specificity of 80% (area under curve = 0.833). In the multivariate analysis, the presence of low muscle density was a significant risk factor for postoperative complications (p = 0.0225).

CONCLUSION

The preoperative skeletal muscle density may serve as a simple and objective surrogate marker for sarcopenia. It might be a useful predictor of postoperative complications after highly invasive surgery for upper abdominal cancer.