Accuracy of surgeons for predicting radiological sarcopenia in colorectal cancer surgery

J Surg Oncol. 2024 Sep;130(4):838-843. doi: 10.1002/jso.27652. Epub 2024 Apr 18.

Abstract

Background: This study explored the performance of surgeons for predicting radiological sarcopenia as accessed by psoas cross-sectional area in patients with colorectal cancer (CRC).

Methods: A cross-sectional study was carried out and a diagnostic accuracy strategy was applied using the radiologist team assessment as gold standard.

Results: Cohort analysis of 45 consecutive patients found that 31.1% had sarcopenia. Correlation of Total Psoas Index between radiologists and surgeons was very strong for the Junior and strong for the Senior surgeon, with a strong correlation between the surgeons. By the simplistic criterion, agreement between radiologists and surgeons was substantial for both the Junior and Senior surgeons, with a moderate level between the surgeons. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Junior surgeon were 92.9%, 83.9%, 72.2%, 96.3%, and 86.7%, respectively. The corresponding results for the Senior surgeon were 78.6%, 90.3%, 78.6%, 90.3%, and 86.7%, respectively. We found no major differences on agreement levels and performance of surgeons using the composite criterion.

Conclusions: Surgeons seem to be accurate for identifying radiological sarcopenia in patients with CRC. The simplistic criterion should be preferred since a composite criterion adds complexity without increasing accuracy or agreement levels.

Keywords: CT scan; X‐ray; colorectal neoplasms; frailty; malnutrition; sarcopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms* / diagnostic imaging
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Psoas Muscles / diagnostic imaging
  • Psoas Muscles / pathology
  • Sarcopenia* / diagnostic imaging
  • Surgeons*