Effects of body composition profiles on oncological outcomes and postoperative intraabdominal infection following colorectal cancer surgery

Perrin, Thomas; Lenfant, Marc; Boisson, Cyrile; Bert, M.; Rat, Patrick; Facy, Olivier

doi:10.1016/j.soard.2020.10.022

Cited by 7 publications

(5 citation statements)

References 49 publications

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“…Recently, adipose tissue has also emerged as a prognostic marker in cancer patients, although with substantial differences according to its anatomical distribution. SAT is considered a positive prognostic factor in cancer patients given its function of energetic storage [30]; indeed, rapid depletion of SAT has been independently associated with worse OS in patients affected by hepatocellular carcinoma during sorafenib treatment [31]. On the other hand, IMAT content is considered a marker of poor skeletal muscle quality and a prognostic factor of negative short-and long-term outcomes in cancer patients [17,32].…”

Section: Discussionmentioning

confidence: 99%

Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

Rinninella

Strippoli

Cintoni³

et al. 2021

Nutrients

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Background: The impact of the new chemotherapy, fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) on body composition in gastric cancer (GC) patients remains unknown. We assessed body composition changes of GC patients receiving the FLOT regimen and their impact on treatment outcomes. Methods: Preoperative pre- and post-FLOT computed tomography (CT) scans of advanced GC patients were studied. Lumbar skeletal muscle index (SMI) and adipose indices were calculated before and after FLOT. Results: A total of 26 patients were identified between April 2019 and January 2020. Nineteen patients were sarcopenic at diagnosis. The mean BMI decreased (from 24.4 ± 3.7 to 22.6 ± 3.1; p < 0.0001) as well as the SMI (from 48.74 ± 9.76 to 46.52 ± 9.98; p = 0.009) and visceral adipose index (VAI) (from 49.04 ± 31.06 to 41.99 ± 23.91; p = 0.004) during preoperative FLOT therapy. BMI, SMI, and VAI variations were not associated with toxicity, Response Evaluation Criteria in Solid Tumors (RECIST), response, delay and completion of perioperative FLOT chemotherapy, and the execution of gastrectomy; a decrease of SMI ≥ 5% was associated with a higher Mandard tumor regression grade (p = 0.01). Conclusions: Almost three-quarters (73.1%) of GC patients were sarcopenic at diagnosis. Preoperative FLOT was associated with a further reduction in SMI, BMI, and VAI. These changes were not associated with short-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

Rinninella

Strippoli

Cintoni³

et al. 2021

Nutrients

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“…There were 278 potentially eligible publications on post‐diagnosis adiposity and colorectal cancer outcomes. We excluded 193 publications 45–237 due to specific reasons related to the synthesis (Supplementary Table 5). Finally, 85 publications…”

Section: Resultsmentioning

confidence: 99%

Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

Becerra‐Tomás,

Markozannes,

Cariolou

et al. 2024

Intl Journal of Cancer

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The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta‐analysis on post‐diagnosis adiposity measures (body mass index [BMI], waist circumference, waist‐to‐hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Random‐effects meta‐analyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Meta‐analyses were possible for BMI and all‐cause mortality, colorectal cancer‐specific mortality, and cancer recurrence/disease‐free survival. Non‐linear meta‐analysis indicated a reverse J‐shaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for all‐cause mortality; 95% and 26% for colorectal cancer‐specific mortality; and 37% and 24% for cancer recurrence/disease‐free survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer follow‐up, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposity‐outcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional well‐designed observational studies and interventional trials are needed to provide further clarification.

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“…The degree to which fat distributions impact prognostic outcomes in CRC patients remains a matter of some debate. Higher levels of visceral fat have been linked to a greater risk of disease recurrence and death in some reports ( 7 , 8 , 21 , 22 ), but other studies have failed to observe any relationship between these parameters, and some have even identified subcutaneous fat as a protective factor associated with a lower risk of recurrence ( 23 , 24 ). Here, a high V/S ratio was found to be associated with a greater risk of recurrence, in line with what has been reported previously ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 99%

Computed tomography-measured body composition can predict long-term outcomes for stage I-III colorectal cancer patients

Zhou,

Tian,

et al. 2024

Front. Oncol.

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BackgroundThere remains a pressing need to identify biomarkers capable of reliably predicting prognostic outcomes for colorectal cancer (CRC) patients. As several body composition parameters have recently been reported to exhibit varying levels of prognostic significance in particular cancers, the present study was devised to assess the ability of body composition to predict long-term outcomes for CRC patients with different stages of disease.MethodsIn total, this retrospective analysis enrolled 327 stage I-III CRC patients whose medical records were accessed for baseline demographic and clinical data. Primary outcomes for these patients included disease-free and overall survival (DFS and OS). The prognostic performance of different musculature, visceral, and subcutaneous fat measurements from preoperative computed tomography (CT) scans was assessed.ResultsOver the course of follow-up, 93 of the enrolled patients experienced recurrent disease and 39 died. Through multivariate Cox regression analyses, the visceral/subcutaneous fat area (V/S) ratio was found to be independently associated with patient DFS (HR=1.93, 95% CI: 1.24–3.01, P=0.004), and the skeletal muscle index (SMI) as an independent predictor for OS (HR=0.43, 95% CI: 0.21–0.89, P=0.023). Through subgroup analyses, higher V/S ratios were found to be correlated with reduced DFS among patients with stage T3/4 (P=0.011), lymph node metastasis-positive (P=0.002), and TNM stage III (P=0.002) disease, whereas a higher SMI was associated with better OS in all T stages (P=0.034, P=0.015), lymph node metastasis-positive cases (P=0.020), and in patients with TNM stage III disease (P=0.020).ConclusionBoth the V/S ratio and SMI offer potential utility as clinical biomarkers associated with long-term CRC patient prognosis. A higher V/S ratio and a lower SMI are closely related to poorer outcomes in patients with more advanced disease.

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Effects of body composition profiles on oncological outcomes and postoperative intraabdominal infection following colorectal cancer surgery

Cited by 7 publications

References 49 publications

Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

Body Composition Changes in Gastric Cancer Patients during Preoperative FLOT Therapy: Preliminary Results of an Italian Cohort Study

Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

Computed tomography-measured body composition can predict long-term outcomes for stage I-III colorectal cancer patients

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