Muscle loss 6 months after surgery predicts poor survival of patients with non-metastatic colorectal cancer

被引:5
作者
Zhang, Liang [1 ,2 ]
Guan, Junjie [3 ]
Ding, Chao [2 ]
Feng, Min [2 ]
Gong, Longbo [1 ]
Guan, Wenxian [2 ]
机构
[1] Xuzhou Cent Hosp, Dept Gastrointestinal Surg, Xuzhou, Peoples R China
[2] Nanjing Med Univ, Dept Gen Surg, Drum Tower Clin Med Coll, Nanjing, Jiangsu, Peoples R China
[3] Nanjing Univ Tradit Chinese Med, Jiangsu Prov Hosp Chinese Med, Dept Gen Surg, Affiliated Hosp, Nanjing, Jiangsu, Peoples R China
来源
FRONTIERS IN NUTRITION | 2022年 / 9卷
关键词
colorectal cancer; sarcopenia; skeletal muscle loss; visceral adipose tissue; survival; BODY-COMPOSITION; SKELETAL-MUSCLE; SURGICAL OUTCOMES; OBESITY PARADOX; CACHEXIA; IMPACT;
D O I
10.3389/fnut.2022.1047029
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
BackgroundMuscle loss is a common characteristic of cancer-related malnutrition and a predictor of poorer prognosis in oncological patients. This study evaluated the association between altered body composition 6 months after surgery and the prognosis in patients with non-metastatic colorectal cancer. Materials and methodsA total of 314 patients who underwent elective curative surgery were enrolled in the study. The third lumbar CT images on preoperative and 6-months postoperative were collected to calculate the skeletal muscle index (SMI), visceral adiposity index (VATI), and subcutaneous adiposity index (SATI). Sarcopenia was defined by the cut-off values reported in the literature, and risk factors affecting overall survival (OS) and disease-free survival (DFS) in CRC were analyzed using Cox regression models. ResultsEighty-two of 314 patients (26.1%) with CRC were diagnosed with sarcopenia before surgery, the preoperative sarcopenia was not significantly associated with the prognosis of CRC patients. There were significant differences in frequency of complications between patient groups according to sarcopenia (41.5 vs. 21.4%, p = 0.004). The Postoperative LOS (11.21 +/- 3.04 vs. 8.92 +/- 2.84, p < 0.001) was longer in the sarcopenia group than in the non-sarcopenia group, and 30-d readmission (24.4 vs. 6.0%, p < 0.001) was higher in the sarcopenia group compared to the non-sarcopenia group. In multivariate analysis, 6-months SMI loss > 10% after surgery was independently associated with poorer OS [hazard ratio (HR) = 3.74; 95% confidence interval (CI) 1.96 to 7.12; P < 0.001] and DFS (HR = 3.33; 95% CI, 1.71 to 6.47; P < 0.001). SMI changes were moderately correlated with changes in body mass index (BMI) (R = 0.47, P < 0.001). Conclusion6-months muscle loss after surgery may affect overall and disease-free survival and was an independent predictor of prognosis in patients with CRC.
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页数:9
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共 24 条
  • [1] Skeletal muscle wasting in cachexia and sarcopenia: molecular pathophysiology and impact of exercise training
    Bowen, T. Scott
    Schuler, Gerhard
    Adams, Volker
    [J]. JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE, 2015, 6 (03): : 197 - 207
  • [2] Weight stability masks changes in body composition in colorectal cancer: a retrospective cohort study
    Brown, Justin C.
    Caan, Bette J.
    Feliciano, Elizabeth M. Cespedes
    Xiao, Jingjie
    Weltzien, Erin
    Prado, Carla M.
    Kroenke, Candyce H.
    Castillo, Adrienne
    Kwan, Marilyn L.
    Meyerhardt, Jeffrey A.
    [J]. AMERICAN JOURNAL OF CLINICAL NUTRITION, 2021, 113 (06) : 1482 - 1489
  • [3] Cancer Cachexia: Beyond Weight Loss
    Bruggeman, Andrew R.
    Kamal, Arif H.
    LeBlanc, Thomas W.
    Ma, Joseph D.
    Baracos, Vickie E.
    Roeland, Eric J.
    [J]. JOURNAL OF ONCOLOGY PRACTICE, 2016, 12 (11) : 1163 - +
  • [4] Caan BJ, 2018, JAMA ONCOL, V4, P798, DOI 10.1001/jamaoncol.2018.0137
  • [5] Caan BJ, 2017, CANCER EPIDEM BIOMAR, V26, P1008, DOI [10.1158/1055-9965.EPI-17-0200, 10.1158/1055-9965.epi-17-0200]
  • [6] Chen H D, 2020, Zhonghua Liu Xing Bing Xue Za Zhi, V41, P1627, DOI 10.3760/cma.j.cn112338-20200423-00629
  • [7] Impact of Visceral Obesity and Sarcopenia on Short-Term Outcomes After Colorectal Cancer Surgery
    Chen, Wei-Zhe
    Chen, Xiao-Dong
    Ma, Liang-Liang
    Zhang, Feng-Min
    Lin, Ji
    Zhuang, Cheng-Le
    Yu, Zhen
    Chen, Xiao-Lei
    Chen, Xiao-Xi
    [J]. DIGESTIVE DISEASES AND SCIENCES, 2018, 63 (06) : 1620 - 1630
  • [8] EXERCISE TRAINING AND NUTRITIONAL SUPPLEMENTATION FOR PHYSICAL FRAILTY LN VERY ELDERLY PEOPLE
    FIATARONE, MA
    ONEILL, EF
    RYAN, ND
    CLEMENTS, KM
    SOLARES, GR
    NELSON, ME
    ROBERTS, SB
    KEHAYIAS, JJ
    LIPSITZ, LA
    EVANS, WJ
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (25) : 1769 - 1775
  • [9] The Impact of Muscle and Adipose Tissue on Long-term Survival in Patients With Stage I to III Colorectal Cancer
    Hopkins, Jessica J.
    Reif, Rebecca L.
    Bigam, David L.
    Baracos, Vickie E.
    Eurich, Dean T.
    Sawyer, Michael B.
    [J]. DISEASES OF THE COLON & RECTUM, 2019, 62 (05) : 549 - 560
  • [10] Nutritional Risk Screening Predicts Tumor Response in Lung Cancer Patients
    Illa, Petr
    Tomiskova, Marcela
    Skrickova, Jana
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF NUTRITION, 2015, 34 (05) : 425 - 429