Sarcopenia and postoperative outcomes in patients with peritoneal carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

PURPOSE: To determine the association between preoperative computed tomography (CT)-measured sarcopenia and short-term postoperative outcomes in patients with peritoneal carcinomatosis (PC) undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). In addition, specific objectives included determining the prevalence of sarcopenia, evaluating the association of postoperative prognosis and outcomes, and assessing the prevalence of postoperative complications in this population undergoing CRS-HIPEC.

MATERIALS AND

METHODS

Retrospective observational study included patients with PC undergoing CRS + HIPEC at a specialized center. Sarcopenia was assessed on preoperative CT using the skeletal muscle index (SMI) at the L3 level. Postoperative outcomes and survival were analyzed using standard univariable and multivariable statistical methods.

RESULTS

No significant differences in short-term postoperative outcomes were observed between sarcopenic and non-sarcopenic patients. Overall survival did not differ significantly between groups. However, sarcopenia was independently associated with shorter disease-free survival (DFS) and a higher risk of recurrence.

CONCLUSION

Sarcopenia was independently associated with shorter DFS and a higher risk of recurrence, supporting its role as a prognostic marker rather than a driver of perioperative morbidity. Preoperative identification may improve risk stratification and guide long-term follow-up, while prospective studies are needed to determine whether targeted interventions can improve outcomes.