Preoperative Sarcopenia and Postoperative Outcomes in Older Patients With Gastrointestinal Cancer

Sarcopenia is characterized by reduced muscle strength, muscle mass, and physical performance and may be associated with unfavorable postoperative outcomes in older patients with cancer. This prospective, single-center observational cohort study will include patients aged 60 years or older who are scheduled to undergo elective surgery for gastrointestinal cancer at Van Training and Research Hospital.

Before surgery, demographic and clinical characteristics, including age, sex, and cancer diagnosis, will be recorded. Sarcopenia will be evaluated according to the EWGSOP2 criteria using measurements of muscle strength, muscle mass, and physical performance. The SARC-F questionnaire and calf circumference measurement will also be performed as part of the preoperative assessment.

Participants will receive standard surgical and perioperative care, and no treatment or intervention will be assigned by the study protocol. Patients will be observed for 90 days after surgery. Outcomes will include postoperative surgical complications, length of hospital stay, 30-day mortality, and 90-day mortality. Postoperative complications of interest will include anastomotic leakage, wound-related complications, oral intake intolerance, and delayed mobilization. The study will compare these outcomes between patients with and without preoperative sarcopenia and assess whether sarcopenia is independently associated with adverse postoperative outcomes.

Inclusion criteria

• Age 60 years or older
• Diagnosis of gastrointestinal system cancer
• Scheduled to undergo elective surgical treatment
• Considered operable based on routine clinical evaluation
• Ability to complete the preoperative sarcopenia assessments
• Provision of written informed consent

Exclusion criteria

• Age younger than 60 years
• Undergoing emergency surgery
• Inability to complete the required preoperative sarcopenia assessment