Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery

Tolga Olmez 1 * , Can Ibrahim Bulut 2, Askin Kadir Percem 3, Aziz Serkan Senger 3, Selcuk Gulmez 3, Orhan Uzun 3, Erdal Polat 3, Mustafa Duman 3
More Detail
1 Department of Gastrointestinal Surgery, Adana City Training and Research Hospital, Adana, Turkey
2 Department of Gastrointestinal Surgery, Balikesir City Hospital, Balikesir, Turkey
3 Department of Gastrointestinal Surgery, Kartal Kosuyolu High Speciality Training and Research Hospital, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 18, Issue 2, pp. 57-60.
Download Full Text (PDF)


Aim: Sarcopenia is a skeletal muscle disorder associated with decreased muscle mass and functional capacity. The SARC-F questionnaire facilitates sarcopenia screening in elderly patients. The present study investigates the applicability of the SARC-F questionnaire to sarcopenia screening in patients scheduled for gastrointestinal (GI) cancer surgery and its relationship with postoperative outcomes.
Methods: This cross-sectional study was carried out with elderly patients scheduled for GI cancer surgery. The study included 71 patients consisting of 47 males and 24 females. The risk of sarcopenia was assessed by the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falling (SARC-F) questionnaire. Patients with a SARC-F score ≥4 were considered to be at risk of sarcopenia. The demographic data, nutritional status and comorbidity data of the patients were recorded. Statistical analysis was conducted to assess postoperative complications in those patients at risk of sarcopenia.
Results: The mean age of 71 study patients was 72.6 ± 5.6 years. There were 15 (21.1%) patients with a SARC-F score ≥ 4. The postoperative complication rate was 60% in patients with a SARC-F score ≥ 4 in comparison with 28.5% of those with a SARC-F score < 4, and the difference was statistically significant (p=0.024). The SARC-F score ≥ 4 group also had a longer hospital stay (p<0.001). Furthermore, the univariate analysis for postoperative complications revealed that SARC-F scores ≥ 4, age ≥ 75 years, and BMI ≥ 30 kg/m2 were statistically significant.
Conclusion: We believe that the SARC-F questionnaire has a place in sarcopenia screening in patients scheduled for GI surgery, and it is possible to predict postoperative adverse outcomes.


Olmez T, Bulut CI, Percem AK, Senger AS, Gulmez S, Uzun O, et al. Interpretation of the SARC-F questionnaire in patients undergoing gastrointestinal cancer surgery. J CLIN MED KAZ. 2021;18(2):57-60.


  • Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
  • Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing. 2010;39:412–23.
  • Barbosa-Silva TG, Menezes AMB, Bielemann RM, Malmstrom TK, Gonzalez MC; Grupo de Estudos em Composição Corporal e Nutrição (COCONUT). Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016;17(2):1136–41.
  • Olmez T, Karakose E, Bozkurt H, Pence H, Gulmez S, Aray E et al. Sarcopenia is associated with increased severe postoperative complications after colon cancer surgery. Arch Med Sci. Accepted article: Sept 12, 2019. Published Online: Oct 09, 2019.
  • Vashi PG, Gorsuch K, Wan L, Hill D, Block C, Gupta D. Sarcopenia supersedes subjective global assessment as a predictor of survival in colorectal cancer. PLoS One. 2019;14(6):1–14.
  • Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14:531–2.
  • Malmstrom TK, Miller DK, Simonsick EM, Ferrucci L MJ. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7:28–36.
  • Soares JDP, Gomes TLN, Siqueira JM, Oliveira ICL, Mota JF, Laviano A et al. Muscle function loss is associated with anxiety in patients with gastrointestinal cancer. Clin Nutr ESPEN. 2019;29:149–53.
  • Ha Y-C, Won Won C, Kim M, Chun K-J, Yoo J-I. SARC-F as a Useful Tool for Screening Sarcopenia in Elderly Patients with Hip Fractures. J Nutr Heal Aging. 2020;24(1):78–82.
  • Borges TC, Gomes TLN, Pimentel GD. Sarcopenia as a predictor of nutritional status and comorbidities in hospitalized patients with cancer: A cross-sectional study. Nutrition. 2020;73:110703.
  • Rolland Y, Dupuy C, Abellan Van Kan G, Cesari M, Vellas B, Faruch M et al. Sarcopenia Screened by the SARC-F Questionnaire and Physical Performances of Elderly Women: A Cross-Sectional Study. J Am Med Dir Assoc. 2017;18(10):848–52.
  • Trejo-Avila M, Bozada-Gutiérrez K, Valenzuela-Salazar C, Herrera-Esquivel J, Moreno-Portillo M. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Color Dis. Accepted Article: Jan 8, 2021. Published online: Jan 22,2021.