Association between specific presurgical anthropometric indexes and morbidity in patients undergoing rectal cancer resection

Abstract Purpose Baseline body composition has been associated with dismal outcome in patients undergoing a variety of major abdominal operations. Whether specific anthropometric indexes can predict morbidity after rectal resection is poorly investigated. Methods Computed tomography-derived measures of skeletal muscle and adipose tissue areas of patients operated for rectal cancer between January 2009 and December 2016 were used to calculate population-specific thresholds of sarcopenia, subcutaneous adiposity, visceral adiposity, visceral obesity, sarcopenic obesity, and myosteatosis. Association between the above body composition features were related with overall complication, infection, and anastomotic leak. Results During the study period 311 patients received an operation and 173 patients were eligible for an accessible preoperative computed tomography imaging. After surgery, 59 (34.1%) patients experienced a complication, 29 an infection, and 10 an anastomotic failure. The overall morbidity rate was observed more frequently in sarcopenic patients than in not sarcopenic ones (39% vs.17.5%; p=0.002), as well as infections (41.4% vs. 21.5% respectively; p=0.024). The presence of myosteatosis was also associated with a higher incidence of overall morbidity (33.9% vs. 20.2% in no myoteatosis; p=0.048). Anastomotic failure occurred in 6/10 patients with visceral obesity and in 24/112 (21.4%) patients without this condition (p=0.007). Conclusions Some anthropometric indexes are accurate predictors of specific types of morbidity. These findings may allow a more accurate preoperative risk stratification.