Harm van Baar1, S Beijer2, M J L Bours3, M P Weijenberg3, M van Zutphen4, F J B van Duijnhoven4, G D Slooter5, J F M Pruijt6, J J Dronkers7, A Haringhuizen8, E J Spillenaar Bilgen9, B M E Hansson10, J H W de Wilt11, E Kampman4, R M Winkels4,12. 1. Division of Human Nutrition, Wageningen University and Research, PO Box 17, 6700 AA, Wageningen, The Netherlands. harm.vanbaar@wur.nl. 2. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. 3. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. 4. Division of Human Nutrition, Wageningen University and Research, PO Box 17, 6700 AA, Wageningen, The Netherlands. 5. Department of Surgery, Maxima Medical Centre, Veldhoven, The Netherlands. 6. Department of Medical Oncology, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands. 7. Department of Physiotherapy, Gelderse Vallei Hospital, Ede, The Netherlands. 8. Department of Medical Oncology, Gelderse Vallei Hospital, Ede, The Netherlands. 9. Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. 10. Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. 11. Department of Surgery, Radboud Universitair Medisch Centrum, Nijmegen, The Netherlands. 12. Department of Public Health Sciences, Penn State College of Medicine, Penn State University, Hershey, PA, USA.
Abstract
BACKGROUND: In cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I-III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. METHODS: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. RESULTS: The median follow-up time was 48 months (range 0-119 months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53-2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95% CI 1.55-2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14-2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89-3.17) in a subset of the study population. CONCLUSION: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.
BACKGROUND: In cancerpatients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I-III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. METHODS: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. RESULTS: The median follow-up time was 48 months (range 0-119 months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53-2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95% CI 1.55-2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14-2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89-3.17) in a subset of the study population. CONCLUSION: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.
Authors: Sami Antoun; Emilie Lanoy; Roberto Iacovelli; Laurence Albiges-Sauvin; Yohann Loriot; Mansouriah Merad-Taoufik; Karim Fizazi; Mario di Palma; Vickie E Baracos; Bernard Escudier Journal: Cancer Date: 2013-06-25 Impact factor: 6.860
Authors: Candyce H Kroenke; Carla M Prado; Jeffrey A Meyerhardt; Erin K Weltzien; Jingjie Xiao; Elizabeth M Cespedes Feliciano; Bette J Caan Journal: Cancer Date: 2018-05-24 Impact factor: 6.860
Authors: Susanne Blauwhoff-Buskermolen; Kathelijn S Versteeg; Marian A E de van der Schueren; Nicole R den Braver; Johannes Berkhof; Jacqueline A E Langius; Henk M W Verheul Journal: J Clin Oncol Date: 2016-02-22 Impact factor: 44.544
Authors: Rebecca L Siegel; Kimberly D Miller; Stacey A Fedewa; Dennis J Ahnen; Reinier G S Meester; Afsaneh Barzi; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2017-03-01 Impact factor: 508.702
Authors: Hánah N Rier; Agnes Jager; Stefan Sleijfer; Joost van Rosmalen; Marc C J M Kock; Mark-David Levin Journal: Breast Date: 2016-10-27 Impact factor: 4.380
Authors: Eline H van Roekel; Martijn J L Bours; Carin P M de Brouwer; Huib Ten Napel; Silvia Sanduleanu; Geerard L Beets; I Jmert Kant; Matty P Weijenberg Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-05-06 Impact factor: 4.254
Authors: Lisa Martin; Laura Birdsell; Neil Macdonald; Tony Reiman; M Thomas Clandinin; Linda J McCargar; Rachel Murphy; Sunita Ghosh; Michael B Sawyer; Vickie E Baracos Journal: J Clin Oncol Date: 2013-03-25 Impact factor: 44.544
Authors: Maryam Ebadi; Lisa Martin; Sunita Ghosh; Catherine J Field; Richard Lehner; Vickie E Baracos; Vera C Mazurak Journal: Br J Cancer Date: 2017-06-06 Impact factor: 7.640
Authors: David P J van Dijk; Maikel J A M Bakens; Mariëlle M E Coolsen; Sander S Rensen; Ronald M van Dam; Martijn J L Bours; Matty P Weijenberg; Cornelis H C Dejong; Steven W M Olde Damink Journal: J Cachexia Sarcopenia Muscle Date: 2016-10-26 Impact factor: 12.910