Skeletal muscle gauge as a prognostic factor in patients with colorectal cancer

被引:16
作者
Park, In Kyu [1 ]
Yang, Song Soo [1 ]
Chung, Eric [2 ]
Cho, Eun-Suk [3 ]
Lee, Hye Sun [4 ]
Shin, Su-Jin [5 ]
Im, Yeong Cheol [1 ]
Park, Eun Jung [6 ]
Baik, Seung Hyuk [6 ]
Lee, Kang Young [7 ]
Kang, Jeonghyun [6 ]
机构
[1] Univ Ulsan, Ulsan Univ Hosp, Dept Surg, Coll Med, Ulsan, South Korea
[2] Indiana Univ, Dept Anesthesiol, Indianapolis, IN 46204 USA
[3] Yonsei Univ, Gangnam Severance Hosp, Dept Radiol, Coll Med, Seoul, South Korea
[4] Yonsei Univ, Biostat Collaborat Unit, Coll Med, Seoul, South Korea
[5] Yonsei Univ, Gangnam Severance Hosp, Dept Pathol, Coll Med, Seoul, South Korea
[6] Yonsei Univ, Gangnam Severance Hosp, Dept Surg, Coll Med, 211 Eonju Ro, Seoul 06273, South Korea
[7] Yonsei Univ, Severance Hosp, Dept Surg, Coll Med, Seoul, South Korea
来源
CANCER MEDICINE | 2021年 / 10卷 / 23期
关键词
colorectal cancer; myosteatosis; sarcopenia; skeletal muscle gauge; skeletal muscle index; skeletal muscle radiodensity; BODY-COMPOSITION; MASS; SARCOPENIA; RADIODENSITY; SURVIVAL; OBESITY; CHEMOTHERAPY; EPIDEMIOLOGY; TOXICITY; OUTCOMES;
D O I
10.1002/cam4.4354
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Although skeletal muscle index (SMI) and radiodensity (SMD) are well-known prognostic factors, the clinical impact of the integrated measure, known as skeletal muscle gauge (SMG), has been limited in patients with colorectal cancer (CRC). Patients and Methods A total of 727 and 268 patients with CRC at two tertiary centers were included and allocated into the training and test sets, respectively. Preoperative slice computed tomography images of the third lumbar area were evaluated for SMI and SMD. SMG was calculated as SMI x SMD and expressed as an arbitrary unit (AU). The optimal cutoff SMG value was determined to maximize the overall survival (OS) difference between the groups with respect to sex in the training set. The multivariate Cox proportional hazard model evaluated the association of its clinical significance. Results With regard to SMG, 1640 and 1523 AU were identified as cutoff values for males and females, respectively. The patients with low SMG values showed significantly worse 5-year OS than those with high SMG values in the two datasets (both p < 0.001). In the multivariate analysis, low SMG was identified as an independent poor prognostic factor of OS in the training set (hazard ratio 2.18, 95% confidence interval 1.43-3.32, p < 0.001) and test set (hazard ratio 1.79, 95% confidence interval 1.07-3.00, p = 0.025), whereas SMI and SMD were not. Conclusion SMG acts synergistically to improve its prognostic predictive accuracy as compared with SMI or SMD alone in patients with CRC. Additional research is warranted to define its significance in different ethnic groups.
引用
收藏
页码:8451 / 8461
页数:11
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