Preoperative Strength, Assistance in Walking, Rising From a Chair, Climbing Stairs, and Falls (SARC‐F) Score Predicts Adjuvant Chemotherapy Discontinuation in Patients With Colorectal Cancer

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BACKGROUND AND OBJECTIVES: Sarcopenia adversely affects clinical outcomes in patients with cancer. Studies indicate that sarcopenia significantly predicts chemotherapy-induced dose-limiting toxicities, including early discontinuation, delay, and dose-reduction, in patients with colorectal, esophageal, digestive, hepatocellular, and renal cancers. The Strength, Assistance for walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire is a simple and effective tool for sarcopenia screening. Adjuvant chemotherapy is the standard treatment for advanced (Stages II/III) colorectal cancer (CRC). Predicting chemotherapy discontinuation could help improve oncologic outcomes. This study aimed to evaluate the correlation between the SARC-F score and chemotherapy discontinuation. METHODS: This study included 139 patients with CRC who underwent surgery between July 2016 and June 2023, received adjuvant chemotherapy and completed the SARC-F questionnaire before surgery. The SARC-F includes five items, each scored from 0 to 2. Patients were divided into two groups based on optimal SARC-F cutoff value. Treatment discontinuation was analyzed using a logistic regression model. RESULTS: Patients were categorized into high-SARC-F (n = 18) and low-SARC-F (n = 121) groups. Patients in the high-SARC-F group were older (p < 0.001), had higher rates of hypertension (p = 0.001) and diabetes mellitus (p = 0.017), elevated preoperative C-reactive protein levels (p < 0.001), and a higher incidence of treatment discontinuation (p = 0.010). Univariate and multivariate analyses identified a high SARC-F score as an independent risk factor for chemotherapy discontinuation (odds ratio 3.905, 95% confidence interval 1.100-13.867). CONCLUSIONS: Our findings indicate that the SARC-F score reflects sarcopenia characteristics and can predict adjuvant chemotherapy discontinuation in patients with CRC.

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