Cancer of Colon
Conditions
Keywords
psoas muscle density, frailty
Brief summary
Colorectal cancer (CRC) is the 3rd most common cancer worldwide. In the UK, CRC is the 4th most common cancer accounting for 12% of cancers diagnosed each year with approximately 41,300 new cases diagnosed in 2014. Surgery remains the only treatment option that can reliably achieve cure from colorectal cancer and thus nearly 20,000 major bowel resections are performed for this yearly in the UK. Surgery for these cancers however carries risk of major complications and potentially death. Selecting appropriate patients for surgery remains a challenge to cancer teams. Risk factors exist for complications after surgery for CRC, many of which can be assessed and discussed with the patient prior to surgery, so that any decision to operate is with fully informed consent from the patient. Increasing attention is being paid to a patient's frailty or fitness as one of these risk factors. Our centre has previously shown that measuring the cross-sectional area of the psoas muscle (a large muscle near the spine) from preoperative imaging could predict major complications in colorectal cancer patients (Jones 2015), however specialist software and patient height is required to make this calculation. More recently we have demonstrated that the measurement of the psoas muscle density on preoperative imaging (i.e. routine CT scans that all patients have before surgery to plan treatment), may potentially be useful to predict which patients are at most risk of a major complication (Herrod 2019). If this finding holds true when tested on a larger scale, it could be used to help surgical teams make the decision on whether to offer surgical resection, what kind of operations to perform, how to best support individuals undergoing operation and to ensure that the patient has the most information available to decide what risk they are at by having major surgery.
Interventions
None listed
Sponsors
University of Nottingham
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient criteria: * Having a major colorectal resection for the treatment of cancer * Elective or emergency surgery * Adults, defined as age ≥18 years of age (no maximum limit) * Had a preoperative CT scan of the abdomen with contrast (portal venous phase) * Operation performed between 31st Aug 2013 - 31st Aug 2019
Exclusion criteria
* Not having a preoperative CT scan with contrast
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of post operative complications (Clavien-Dindo grade 3-4) during inpatient hospital stay. | Through study completion, an average of 10 days. | Recorded post operative complications requiring intervention during post operative stay until initial discharge from hospital. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post operative length of stay | Through study completion, usually between 6-10 days. | Number of days |
| Mortality | Up to 5 year follow up from operation | Recorded patient death |
| Post operative complications beyond hospital discharge. | From hospital discharge to record review (i.e. 30 days, 90 days, 2 - 5 year follow up). | Recorded post operative complications (including re-operation or recurrence) until discharge from surgical clinic or date of record review. |
Countries
United Kingdom
Contacts
Primary ContactJonathan N Lund, MD
Backup ContactJames EM Blackwell, PhD BMBS
Outcome results
None listed