Recent advances in the research of sarcopenia in colorectal cancer

Abstract Colorectal cancer is one of the most common cancers, accounting for 9.4% of new cases. With increasing age, diseases that cause muscle loss, such as sarcopenia, increase morbidity and mortality in patients with colorectal cancer. Therefore, the aim of this paper is to critically assess the available evidence on the combined impact of sarcopenia on colorectal cancer patients and to draw some practical conclusions to support the multidisciplinary management of patients with sarcopenic colorectal cancer. We summarized literature including cohort studies, randomized controlled trials, and validation studies, focusing on six key aspects: pathogenesis, risk factors, clinical impact, assessment and diagnostic criteria, management and interventions, and perspectives on sarcopenia in colorectal cancer patients. The results indicate that sarcopenia is closely associated with chronic systemic inflammatory responses, oxidative damage from free radicals, autophagic programmed cell death in skeletal muscle, and mitochondrial dysfunction in skeletal muscles. Sarcopenia severely impacts the prognosis and increases the toxicity of chemotherapy responses in colorectal cancer patients while exacerbating postoperative complications. Only through early diagnosis and screening, nutritional intervention, exercise intervention, modulation of intestinal flora, and pharmacological intervention can the impact of sarcopenia on colorectal cancer patients be effectively ameliorated at the source.