EP273 - Association Between Clinical Frailty Score, Body Anthropometric Measures, and Clinical Outcomes in Colorectal Cancer Patients

Purpose/Background: Despite advances in perioperative optimisation and surgical techniques, colorectal cancer remains associated with significant morbidity and mortality. Frailty and adverse body composition, such as sarcopenia and myosteatosis, are recognised predictors of poor surgical outcomes. This study examined the association between anthropometric measurements, frailty, and clinical outcomes in patients undergoing treatment for colorectal cancer.

Methods/Interventions: Consecutive patients undergoing colorectal resection for cancer were recruited prospectively between 2021-2022. Demographics, comorbidities, and handgrip strength were recorded. Charlson Comorbidity Index (CCI) and Clinical Frailty Score (CFS) were calculated. Skeletal muscle index and muscle attenuation were measured from staging CT scans using OSIRIX software. Logistic regression identified factors associated with postoperative complications and readmissions. Linear regression assessed length of stay, and Cox proportional hazards analysis assessed recurrence-free and overall survival.

Results/Outcomes: Eighty-eight patients were included; 59 (67%) were male and the median age was 68 years (Interquartile range 69-84). Eleven (13%) were frail (CFS ≥ 4), and 73 (83%) had a high CCI (≥ 4). Thirty-two (36%) were myopenic, 25 (28%) myosteatotic, and seven (8%) sarcopenic. CFS did not differ by myopenia, myosteatosis, or sarcopenia status (all p>0.05). There were no differences in tumour location, treatment approach, or histologic stage between these groups.
CFS was associated with increased risk of postoperative Clavien-Dindo ≥ 2a complications and 90-day readmission (OR 5.06, 95% CI 1.02–25.19, p=0.048). Myopenia was associated with increased risk of Clavien-Dindo ≥ 2a complications and 30-day readmission (OR 2.85, 95% CI 1.10–7.38, p=0.031). Both myosteatosis and sarcopenia were associated with 90-day readmissions (both p< 0.05). Both CFS and myosteatosis were associated with increased length of stay (p < 0.01). There was no difference in recurrence-free or overall survival by frailty or body composition status.

Conclusion/Discussion: Frailty and poor body composition are common in colorectal cancer patients and are associated with both short- and long-term adverse outcomes. These factors can be identified from standard preoperative assessments and staging CT scans. Early identification may enable risk stratification and targeted prehabilitation at diagnosis. Larger studies are warranted to validate these findings.