Mona Shirdel1, Fredrick Andersson2, Robin Myte3, Jan Axelsson4, Martin Rutegård5,6, Lennart Blomqvist7,8,9, Katrine Riklund9,10, Bethany van Guelpen3,6, Richard Palmqvist1, Björn Gylling1. 1. Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden. 2. Department of Medical Biosciences, Clinical chemistry, Umeå University, Umeå, Sweden. 3. Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. 4. Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden. 5. Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden. 6. Wallenberg Centre for Molecular Medicine at Umeå University (WCMM), Umeå, Sweden. 7. Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Stockholm, Sweden. 8. Department of Imagining and Physiology, Karolinska University Hospital, Stockholm, Sweden. 9. Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden. 10. Umeå Centre for Functional Brain Imaging (UFBI), Umeå, Sweden.
Abstract
Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators. Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival. Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.
Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators. Results:Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival. Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.
Authors: Raila Aro; Sanna Meriläinen; Päivi Sirniö; Juha P Väyrynen; Vesa-Matti Pohjanen; Karl-Heinz Herzig; Tero T Rautio; Elisa Mäkäräinen; Reetta Häivälä; Kai Klintrup; Markus J Mäkinen; Juha Saarnio; Anne Tuomisto Journal: J Clin Med Date: 2022-05-09 Impact factor: 4.964
Authors: Francesco Cortiula; Lizza E L Hendriks; Wouter R P H van de Worp; Annemie M W J Schols; Rianne D W Vaes; Ramon C J Langen; Dirk De Ruysscher Journal: J Cachexia Sarcopenia Muscle Date: 2022-01-10 Impact factor: 12.910