背景：肌肉减少症，即与年龄相关的肌肉质量损失，是胃肠癌的负面预后因素。少肌症合并内脏肥胖（少肌症肥胖）与不良预后相关。我们探讨了肥胖和其他因素对诊断为肌少症的结直肠癌患者预后的影响。方法：我们纳入了 211 名术前诊断为肌少性肥胖的结直肠癌患者，这些患者于 2009 年 1 月至 2012 年 1 月期间在大阪大学医院接受了根治性切除术。使用腰肌质量指数评估肌肉质量。通过测量脐部内脏脂肪面积来评估肥胖程度。患者被分为两组：肥胖肌少症（SO）和非肥胖肌少症（非 SO）。比较两组之间的总生存率、癌症特异性生存率和癌症相关无复发生存率（CRFS）。还分析了患者特征，包括年龄、性别、体重指数、血清白蛋白、C反应蛋白、肿瘤标志物、预后营养指数（PNI）、改良格拉斯哥预后评分（mGPS）和老年营养风险指数（GNRI） 。结果：SO 组的 CRRFS 显着短于非 SO 组 (p = 0.028)。 PNI、mGPS 和 GNRI 未被确定为 CRRFS 的重要预后因素。多变量分析强调，少肌性肥胖、癌胚抗原水平升高和不利的组织学类型是 CRRFS 不良结果的重要预测因素。结论：少肌性肥胖是 CRC 患者预后不良的独立预测因素。因此，旨在增加肌肉质量和减少内脏脂肪的干预措施可能会改善这些患者的预后。

Background: Sarcopenia, the age-related loss of muscle mass, is a negative prognostic factor in gastrointestinal cancer. Sarcopenia combined with visceral obesity (sarcopenic obesity) is associated with poor outcomes. We explored the influence of obesity and other factors on the prognosis of patients with colorectal cancer diagnosed with sarcopenia. Methods: We enrolled 211 patients with colorectal cancer diagnosed with preoperative sarcopenic obesity who underwent radical resection at Osaka University Hospital between January 2009 and January 2012. Muscle mass was assessed using the psoas muscle mass index. Obesity was evaluated by measuring the visceral fat area in the umbilical region. Patients were categorized into two groups: sarcopenia with obesity (SO) and sarcopenia without obesity (non-SO). Overall survival, cancer-specific survival, and cancer-related relapse-free survival (CRRFS) were compared between the two groups. Patient characteristics, including age, sex, body mass index, serum albumin, C-reactive protein, tumor markers, prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and geriatric nutritional risk index (GNRI), were also analyzed. Results: CRRFS was significantly shorter in the SO group than in the non-SO group (p = 0.028). PNI, mGPS, and GNRI were not identified as significant prognostic factors for CRRFS. Multivariate analysis highlighted sarcopenic obesity, elevated carcinoembryonic antigen levels, and unfavorable histological types as significant predictors of poor CRRFS outcomes. Conclusions: Sarcopenic obesity is an independent predictor of poor prognosis in patients with CRC. Thus, interventions aimed at increasing muscle mass and reducing visceral fat could potentially improve the prognosis of these patients.