American Journal of Translational Research · Jan 1, 2026

The impact of nutritional risk and sarcopenia on postoperative complications and survival outcomes in elderly patients undergoing colorectal cancer surgery: a retrospective cohort study

By Yuan C, Mao Y, Chen H

OBJECTIVE: To investigate individual and combined effects of preoperative nutritional risk and sarcopenia on postoperative complications and survival in elderly colorectal cancer (CRC) patients. METHODS: Data from 260 elderly patients (>60 years) undergoing radical CRC surgery (2022-2024) were retrospectively analyzed. Nutritional risk was assessed by NRS-2002 (score ≥3). Sarcopenia was diagnosed by AWGS 2019 criteria (handgrip strength + CT muscle index). Patients were grouped into No-risk, Nutritional risk only, Sarcopenia only, and Combined. OUTCOMES: Overall (Clavien-Dindo ≥II) and severe (≥IIIa) complications, and overall survival. Multivariate Cox regression was used. RESULTS: Mean age 68.08±5.32 years. Nutritional risk prevalence 44.6% (116/260), sarcopenia 28.5% (74/260), coexistence 16.2% (42/260). The Combined group had highest overall complication rate (64.3% vs. 15.2% in No-risk, P<0.001) and severe complication rate (23.8% vs. 7.1%, P = 0.007). Median follow-up 18 months; Combined group lowest 18-month survival (69.0% vs. 96.4%, P<0.001). Multivariate Cox regression (adjusting for age, sex, BMI) showed Nutritional risk only (HR = 3.954, 95% CI: 1.369-11.420, P = 0.011) and Sarcopenia only (HR = 4.095, 95% CI: 1.181-14.195, P = 0.026) were poor prognostic indicators. Coexistence was the strongest predictor (HR = 10.173, 95% CI: 3.699-27.977, P<0.001). CONCLUSION: Preoperative coexistence of nutritional risk and sarcopenia significantly increases complications and reduces survival in elderly CRC patients, with risks far exceeding single factors. Routine dual assessment and intensive prehabilitation should be implemented.

doi.org/10.62347/gxlr1059 Open access PubMed 42325799 Biomarkers