Preoperative Sarcopenia and Postoperative Morbidity after Surgery for Gastric and Colon Cancer: A Single- Center Observational Study

Masashi Ishikawa, Yoshihiko Tashiro, Masami Morimoto, Hirokazu Takechi, Kazuo Matsuyama and Takayuki Miyauchi

Department of Surgery, Shikoku Central Hospital, Japan

^*Correspondance to: Masashi Ishikawa 

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Abstract:

Background: Sarcopenia is increasingly being recognized as a clinically relevant marker of physiological vulnerability in patients undergoing cancer surgery. However, its effect on short-term postoperative morbidity and long-term outcomes after gastric and colon cancer surgery remains insufficiently defined, particularly in small community-based cohorts assessed using the Asian Working Group for Sarcopenia (AWGS) 2014 criteria. Methods: This retrospective, observational study included 41 patients who underwent surgery for gastric or colon cancer at a single institution in Japan. Preoperative sarcopenia was assessed using bioelectrical impedance analysis and handgrip strength, according to the AWGS 2014 criteria. The patients were classified into sarcopenia and non-sarcopenia groups. The short-term outcomes included overall postoperative complications and surgical site infections (SSI). The long-term outcomes included overall survival and relapse-free survival. Multivariate analysis was performed to evaluate the association between sarcopenia and postoperative complications. Results: Sarcopenia was identified in 21 (51.2%) patients. Patients with sarcopenia were older and had a lower body mass index, skeletal muscle mass index, handgrip strength, and nutritional indices than those without sarcopenia. Overall, postoperative complications were more frequent in the sarcopenia group than in the non-sarcopenia group (38.1% vs. 10.0%), whereas the incidence of SSI was similar between groups. In multivariate analysis, sarcopenia remained associated with postoperative complications, although the wide confidence interval indicated limited precision due to the small number of events. Overall and relapse-free survival tended to be poorer in patients with sarcopenia; however, these differences were not statistically significant. Conclusions: Preoperative sarcopenia assessed using the AWGS 2014 criteria was associated with increased postoperative morbidity after gastric and colon cancer surgery. The absence of a clear association with SSI suggests that sarcopenia may reflect a broader physiological vulnerability than infection-specific risk alone. Routine assessment of muscle mass, muscle strength, and nutritional status may help improve perioperative risk stratification and guide prehabilitation or nutritional intervention.

Keywords:

Sarcopenia; Gastrointestinal cancer; Surgical site infection; Postoperative morbidity; Gastric cancer; Colon cancer

Cite the Article:

Ishikawa M, Tashiro Y, Morimoto M, Takechi H, Matsuyama K, Miyauchi T. Preoperative Sarcopenia and Postoperative Morbidity after Surgery for Gastric and Colon Cancer: A Single- Center Observational Study. World J Surg Surgical Res. 2026; 9: 1626..