Paola De Nardi1, Mariachiara Salandini2, Damiano Chiari2, Nicolò Pecorelli2, Giulia Cristel3, Anna Damascelli3, Monica Ronzoni4, Luca Massimino5, Francesco De Cobelli6, Marco Braga7. 1. Department of Surgery, San Raffaele Scientific Institute, Milan, Italy. Electronic address: denardi.paola@hsr.it. 2. Department of Surgery, San Raffaele Scientific Institute, Milan, Italy. 3. Department of Radiology, San Raffaele Scientific Institute, Milan, Italy. 4. Department of Medical Oncology, San Raffaele Scientific Institute, Milan, Italy. 5. Division of Neurosciences, San Raffaele Scientific Institute, Milan, Italy. 6. Department of Radiology, San Raffaele Scientific Institute, Milan, Italy; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy. 7. Department of Surgery, San Raffaele Scientific Institute, Milan, Italy; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
Abstract
AIM: To establish the correlation between changes in body composition after neoadjuvant chemoradiotherapy (nCRT) and postoperative outcomes, in patients with advanced low rectal cancer. METHODS: Patients with clinical stage T≥3 or N+ rectal cancer who underwent nCRT and surgical resection were studied. Skeletal muscle, visceral, and subcutaneous fat cross-sectional area were measured by computed tomography before and after nCRT. Postoperative morbidity, pathologic response to nCRT, overall and disease-free survival was assessed. RESULTS: Fifty-two patients, median age 62 (range 32-79) were studied. A skeletal muscle loss >2% significantly correlated with a shorter disease-free survival both in the overall population (P = 0.048) and in the subgroup of N0 patients (P = 0.048). A subcutaneous fat loss >5% was also associated with a shorter disease-free survival (P = 0.012) in the whole population. CONCLUSIONS: Skeletal muscle loss, after neoadjuvant chemoradiotherapy, negatively impacts on disease-free survival in surgically treated rectal cancer patients.
AIM: To establish the correlation between changes in body composition after neoadjuvant chemoradiotherapy (nCRT) and postoperative outcomes, in patients with advanced low rectal cancer. METHODS:Patients with clinical stage T≥3 or N+ rectal cancer who underwent nCRT and surgical resection were studied. Skeletal muscle, visceral, and subcutaneous fat cross-sectional area were measured by computed tomography before and after nCRT. Postoperative morbidity, pathologic response to nCRT, overall and disease-free survival was assessed. RESULTS: Fifty-two patients, median age 62 (range 32-79) were studied. A skeletal muscle loss >2% significantly correlated with a shorter disease-free survival both in the overall population (P = 0.048) and in the subgroup of N0 patients (P = 0.048). A subcutaneous fat loss >5% was also associated with a shorter disease-free survival (P = 0.012) in the whole population. CONCLUSIONS: Skeletal muscle loss, after neoadjuvant chemoradiotherapy, negatively impacts on disease-free survival in surgically treated rectal cancerpatients.