Abstract

Objectives:

Sarcopenia and low muscle mass are distinct clinical conditions associated with adverse outcomes after colorectal cancer (CRC) surgery. Due to limited effective screening methods, we evaluated the diagnostic performance of four tools for these conditions in preoperative patients with CRC.

Methods:

This cross-sectional study included patients aged ≥65 years with stage I–III CRC scheduled for elective surgery. Sarcopenia and low appendicular skeletal muscle mass (ASM) were diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Diagnostic performance of calf circumference (CC), SARC-F, SARC-CalF, and the Ishii score was evaluated.

Results:

Ninety-eight patients (48.0% females, mean age 77.4 ± 6.2 years) were included. Prevalences of low ASM and sarcopenia were 56.1% and 41.8%, respectively. For low ASM, CC demonstrated the highest accuracy (AUC 0.907, sensitivity 80.0%, specificity 86.0%), significantly outperforming SARC-F and SARC-CalF (AUCs 0.617 and 0.854; p<0.005), and comparable to the Ishii score (AUC 0.895). For sarcopenia, the Ishii score exhibited the highest accuracy (AUC 0.957, sensitivity 100%, specificity 75.4%), significantly surpassing CC, SARC-F, and SARC-CalF (AUCs 0.875, 0.704, and 0.865; p<0.001).

Conclusions:

The Ishii score demonstrated superior diagnostic performance for sarcopenia, underscoring the importance of muscle strength assessment for effective screening.