The Association of CT-Assessed Sarcopenia and Nutritional Status with Postoperative Outcomes in Pediatric Surgical Oncology

<b>Introduction:</b> Sarcopenia is traditionally associated with aging. However, it has been more frequently discussed in pediatric oncology. Yet, the research on sarcopenia and surgical outcomes in pediatric oncologic patients is quite limited.<b>Aim:</b> Our study aimed to assess the correlation between muscle mass and postoperative outcomes in this population.<b>Materials and methods:</b> We performed a retrospective data analysis of 39 pediatric oncologic patients aged 3 months to 16 years who underwent abdominal and/or pelvic surgery in our facility between 2017 and 2024. We measured the total Psoas Muscle Area (tPMA) on axial CT images and calculated the percentile of tPMA at L3/4 and L4/5 levels of the available benchmark.<b>Results:</b> The number and severity of surgical complications were similar between the sarcopenia and no-sarcopenia groups. However, the length of postoperative stay was significantly higher in the former group. Preoperative parameters best correlating with the number of postoperative adverse events were the percentile of tPMA at L4/L5 and the serum total protein concentration.<b>Discussion:</b> Previous studies on pediatric oncologic patients supported a correlation between sarcopenia and prolonged hospitalization. Moreover, other authors reported an association of sarcopenia with postoperative complications and overall survival.<b>Conclusions:</b> Our findings suggest that muscle mass and nutritional status influence the postoperative course, especially the length of hospitalization, in pediatric oncologic patients. Therefore, they should be addressed in the preoperative workup.<b>Study Significance:</b> The novelty of our study lies in its focus on sarcopenia and surgical outcomes in pediatric patients with malignancies, an area with limited research.