Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients

Han, Jin Soo; Ryu, Hyun; Park, In Ja; Kim, Kyung Won; Shin, Youngbin; Kim, Sun Ok; Lim, Seok‐Byung; Kim, Chan Wook; Yoon, Yong Sik; Lee, Jong Lyul; Yu, Chang Sik; Kim, Jin Cheon

doi:10.4143/crt.2019.249

Cited by 50 publications

(63 citation statements)

References 28 publications

(37 reference statements)

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“…Sarcopenia has been reported to affect survival in various kinds of malignancies, including colorectal cancer [ 8 , 10 , 13 , 14 , 15 ]; however, criteria and measurement of sarcopenia were inconsistent among studies [ 13 , 14 , 16 ]. In most previous studies, the associations between sarcopenia and survival were evaluated for a single timepoint [ 14 , 15 , 16 ]. Although the mechanism through which sarcopenia influences prognosis in patients with cancer is unknown, there is a hypothesis that sarcopenia induces systemic inflammation [ 2 , 14 ], which is also known to increase the risk of cancer and diminish treatment efficacy [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that body composition affected the long-term survival of patients with non-metastatic rectal cancer [ 15 ]; rectal cancer patients with sarcopenic obesity and a low BMI at diagnosis had a negative association with OS. Although we showed that body composition was associated with OS, it could not reflect postoperative changes in body composition.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Postoperative Changes in Sarcopenia on Long-Term Survival in Non-Metastatic Colorectal Cancer Patients

Lee

Park

Kim

et al. 2021

Cancers

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The effect of perioperative sarcopenic changes on prognosis remains unclear. We conducted a retrospective cohort study with 2333 non-metastatic colorectal cancer patients treated between January 2009 and December 2012 at the Asan Medical Center. The body composition at diagnosis was measured via abdominopelvic computed tomography (CT) using Asan-J software. Patients underwent CT scans preoperatively, as well as at 6 months–1 year and 2–3 years postoperatively. The primary outcome was the association between perioperative sarcopenic changes and survival. According to sarcopenic criteria, 1155 (49.5%), 890 (38.2%), and 893 (38.3%) patients had sarcopenia preoperatively, 6 months–1 year, and 2–3 years postoperatively, respectively. The 5-year overall survival (OS) (95.8% vs. 92.1%, hazard ratio (HR) = 2.234, p < 0.001) and 5-year recurrence-free survival (RFS) (93.2% vs. 86.2%, HR = 2.251, p < 0.001) rates were significantly lower in patients with preoperative sarcopenia. Both OS and RFS were lower in patients with persistent sarcopenia 2–3 years postoperatively than in those who recovered (OS: 96.2% vs. 90.2%, p = 0.001; RFS: 91.1% vs. 83.9%, p = 0.002). In multivariate analysis, postoperative sarcopenia was confirmed as an independent factor associated with decreased OS and RFS. Pre- and postoperative sarcopenia and changes in the condition during surveillance were associated with oncological outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of Postoperative Changes in Sarcopenia on Long-Term Survival in Non-Metastatic Colorectal Cancer Patients

Lee

Park

Kim

et al. 2021

Cancers

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“…In addition, lower physical function, decreased resilience to chemotherapy and radiation treatment, and generally worse prognoses are observed in cachectic patients compared to those with stable weight [6]. However, other body composition parameters including muscle quantity and density have recently become a subject of research in the field of cancer prognosis [7].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

et al. 2020

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Background: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women worldwide. Recently, studies have been published with inconsistent findings regarding whether sarcopenia is a risk factor for mortality in breast cancer patients. Therefore, the aim of this systematic review and meta-analysis was to systematically assess and quantify sarcopenia as a risk factor for mortality in breast cancer patients. Methods: In a systematic literature review of PubMed, EMBASE, and the Cochrane CENTRAL Library, we searched for observational studies written in English (from database inception until April 30, 2019) that reported an association between sarcopenia and breast cancer in women who were 18 years or older. Results: A total of six studies (5497 participants) were included in this meta-analysis. Breast cancer patients with sarcopenia were associated with a significantly higher risk of mortality, compared to breast cancer patients without sarcopenia (pooled HR-hazard ratio = 1.71, 95% CI: 1.25-2.33, I 2 = 59.1%). In addition, the results of age subgroup analysis showed that participants younger than 55 years with sarcopenia had a lower risk of mortality than participants aged 55 years and older with sarcopenia (pooled HR = 1.46, 95% CI: 1.24-1.72 versus pooled HR = 1.99, 95% CI: 1.05-3.78), whereas both have an increased risk of mortality compared to non-sarcopenic patients. Subgroup analyses regarding stage at diagnosis revealed an increased risk of mortality in non-metastatic patients compared to participants without sarcopenia (pooled HR = 1.91, 95% CI: 1.32-2.78), whereas the association was not significant in metastatic breast cancer patients. Other subgroup analyses were performed using different follow-up periods (> 5 years versus ≤5 years) and the results were different (pooled HR = 1.81, 95% CI: 1.23-2.65 versus pooled HR = 1.70, 95% CI: 0.80-3.62). Conclusions: The present study found that sarcopenia is a risk factor for mortality among female early breast cancer patients. It is imperative that more research into specific interventions aimed at treating sarcopenia be conducted in the near future in order to provide evidence which could lead to decreased mortality rates in breast cancer patients.

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“…12,13 Many studies only measure baseline/single time point of body compositions to diagnose patients with sarcopenia, sarcopenic obesity or visceral obesity, which sometimes influence but usually do not affect oncological outcomes. 8,14,15,16 Of note, over time, more and more studies have paid more attention to the relationship between changes in body composition and clinical outcomes in cancer patients. Measuring body composition changes over time is necessary to obtain more information about patients.…”

Section: Introductionmentioning

confidence: 99%

Marked loss of adipose tissue during neoadjuvant therapy as a predictor for poor prognosis in patients with gastric cancer: A retrospective cohort study

Zhang

Jiang

et al. 2021

J Human Nutrition Diet

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Background:The influence of body composition changes during neoadjuvant treatment (NT) on long-term survival in patients with gastric cancer (GC) undergoing radical gastrectomy remains unclear. The present study aimed to explore the association between changes in body composition during NT and survival in patients with GC.Methods: GC patients treated with NT and radical gastrectomy between 2015 and 2018 were included in this retrospective study. Skeletal muscle mass, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were measured by computer tomography before and after NT. Body composition changes during NT were compared with Kaplan-Meier curves. Univariate and multivariate regression analyses were applied to determine the predictors of overall survival (OS) and disease-free survival (DFS).Results: In total, 157 GC patients were studied. A marked loss of adipose tissue was associated with poor nutritional status. The median follow-up time for all patients was 25 months. Patients with marked VAT loss (≥ 35.7%) during NT had significantly shorter OS (p = 0.028) and DFS (p = 0.03). Similarly, poorer OS (p = 0.033) and DFS (p = 0.003) were observed in patients with marked SAT loss (≥ 30.1%) during NT. Changes in skeletal muscle mass and body weight during NT were not associated with survival. Marked VAT loss accompanied by marked SAT loss was an independent predictor of OS (hazards ratio = 2.447; p = 0.045) and DFS (hazards ratio = 2.674; p = 0.018). Conclusions: Patients with locally advanced GC have a worse survival when they experienced marked loss of adipose tissue during NT.

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Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients

Cited by 50 publications

References 28 publications

Influence of Postoperative Changes in Sarcopenia on Long-Term Survival in Non-Metastatic Colorectal Cancer Patients

Influence of Postoperative Changes in Sarcopenia on Long-Term Survival in Non-Metastatic Colorectal Cancer Patients

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Marked loss of adipose tissue during neoadjuvant therapy as a predictor for poor prognosis in patients with gastric cancer: A retrospective cohort study

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