Aerobic fitness and muscle density play a vital role in postoperative complications in colorectal cancer surgery

Anne C.M. Cuijpers*, Bart C. Bongers, Aniek F.J.M. Heldens, Martijn J.L. Bours, Nico L.U. van Meeteren, Laurents P.S. Stassen, Tim Lubbers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
19 Downloads (Pure)


Background and Objectives: To assess the association of preoperative aerobic fitness and body composition variables with a patient's resilience to the development and impact of postoperative complications after elective colorectal cancer (CRC) surgery. Methods: Preoperative aerobic fitness was assessed by steep ramp test performance. Preoperative body composition was assessed by muscle mass and density determined from preoperative computed tomography scan analysis at the L3-level. Complication development and severity was graded according to Clavien-Dindo. Complication impact was assessed by the time to recovery of physical functioning after complications. Multivariable logistic regression analyses adjusted for age, sex, comorbidities and tumour location was performed. Results: Of 238 included patients, 96 (40.3%) developed postoperative complications. Better preoperative aerobic fitness decreased the likelihood to develop complications, independent of muscle mass (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.35−0.85) or muscle density (OR: 0.57, 95% CI: 0.36−0.89). A prolonged time to recovery following complications was associated with lower preoperative muscle density (OR: 4.14, 95% CI: 1.28−13.41), independent of aerobic fitness. Conclusions: Lower aerobic fitness increases the risk of complication development, while low muscle density seems associated with a prolonged recovery from complications. Aerobic fitness and muscle density could be valuable additives to preoperative risk assessment.

Original languageEnglish
Pages (from-to)1013-1023
Number of pages11
JournalJournal of Surgical Oncology
Issue number6
Publication statusPublished - May 2022

Bibliographical note

Funding Information:
This study is part of a larger project, the public−private partnership project (PROCLINA), which is co‐funded by an unconditional research grant from Medical Research Data Management (MRDM), as well as by the Ministry of Economic Affairs by means of a PPP Allowance made available by Health~Holland, Top Sector Life Sciences & Health (LSH M17073). Health~Holland encourages innovative research by financially supporting public−private partnerships in the life sciences and health sector, with the aim of developing sustainable and innovative products and services. The consortium has made agreements about the intellectual property (IP) related to the knowledge and products that will be developed in the project. The funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Publisher Copyright:
© 2022 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC


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