Bioelectrical Impedance Analysis for Perioperative Fluid Evaluation in Colorectal Cancer Surgery

Sarcopenia is recognized as an important negative prognostic factor in oncology, independent of malnutrition. It contributes to increased morbidity and mortality, higher incidence of treatment-related toxicity, reduced tolerance to systemic therapy, and impaired functional status. In patients with gastrointestinal malignancies, sarcopenia is common due to tumor-related metabolic changes, reduced intake, inflammation, and the adverse effects of anticancer therapies. The SARC-F questionnaire is a simple, validated screening tool recommended by the European Working Group on Sarcopenia in Older People (EWGSOP2) for the identification of individuals at risk of sarcopenia. It consists of short, function-oriented questions assessing strength, assistance in walking, rising from a chair, climbing stairs, and falls. A SARC-F score of ≥4 indicates increased risk of sarcopenia. This prospective interventional study will include adult patients with gastrointestinal cancer who are candidates for systemic anticancer treatment. Participants will complete the SARC-F questionnaire at baseline, prior to initiation of systemic therapy, and again during treatment. The primary objective is to determine the proportion of patients with positive SARC-F screening results at these time points and to evaluate changes in sarcopenia risk during the course of treatment. Patients who screen positive for sarcopenia risk will be referred to the clinical nutrition outpatient clinic for further assessment, including anthropometric measurements and, where clinically indicated, dual-energy X-ray absorptiometry (DXA). Based on the results, individualized multimodal interventions for the prevention and treatment of sarcopenia will be initiated in collaboration with a multidisciplinary team. The study does not impose additional diagnostic or therapeutic burden beyond standard clinical care. The results are expected to contribute to improved early identification and management of sarcopenia in patients with gastrointestinal cancer.