Prognostic significance of osteosarcopenia in older adults with colorectal cancer

Abstract

Osteopenia and sarcopenia, features of the aging process, are recognized as major health problems in an aging society. This study investigated the prognostic impact of osteosarcopenia, the coexistence of osteopenia and sarcopenia, in older adults undergoing curative resection for colorectal cancer. MethodsWe retrospectively reviewed data of older adults aged 65-98 years who had undergone curative resection for colorectal cancer. Osteopenia was evaluated by bone mineral density measurement in the midvertebral core of the 11th thoracic vertebra on preoperative computed tomography images.Sarcopenia was evaluated by measuring the skeletal muscle cross-sectional area at the third lumbar vertebra level. Osteosarcopenia was de ned as the coexistence of osteopenia and sarcopenia. We explored the relationship of preoperative osteosarcopenia with the disease-free and overall survival after curative resection. ResultsAmong the 325 patients included, osteosarcopenia had signi cantly lower overall survival rates than those with osteopenia (P<0.01) or sarcopenia alone (P=0.036). In the multivariate analysis, male sex (P=0.045), C-reactive protein-to-albumin ratio (P<0.01), osteosarcopenia (P<0.01), pathological T4 stage (P=0.023), and pathological N1/N2 stage (P<0.01) were independent predictors of disease-free survival, while age (P<0.01), male sex (P=0.049), C-reactive protein-to-albumin ratio (P<0.01), osteosarcopenia (P<0.01), pathological T4 stage (P=0.036), pathological N1/N2 stage (P<0.01), and carbohydrate antigen 19-9 (P=0.041) were independent predictors of overall survival. ConclusionsOsteosarcopenia was a strong predictor of poor outcomes in older adults undergoing curative resection for colorectal cancer, suggesting an important role of osteosarcopenia in an aging society.

Preoperative abnormal bone mineral density as a prognostic indicator in patients undergoing gastrectomy for gastric cancer: A cohort study

“…In this study, the elliptical ROI tool was used to define the ROI, ensuring it encompassed the largest circle diameter possible without including the vertebral cortex and posterior venous plexus, aligning with common practices in previous studies using elliptical ROIs. [13,14,[21][22][23][24] However, alternative approaches, including circular ROI, [12,[29][30][31][32][33][34][35] ROI with a fixed surface area, [36] and ROI in the anterior ½ to ¾ of the vertebral body [37] have been used in previous studies.…”

The Role of Exercise in Cancer-Related Sarcopenia and Sarcopenic Obesity

“…The assessment and early detection of sarcopenia is of great importance as it associated with the hospitalisation period, the prognosis and survival of oncology patients, regardless of the type of malignancy and whether it is considered high-risk for the development of sarcopenia. Furthermore, sarcopenic or sarcopenic obese cancer patients sometimes experience decreased bone mineral density, a syndrome defined as osteosarcopenia, which has also been linked with impaired physical functioning and poor prognosis in oncology patients, especially in older adults [181][182][183].…”