Sarcopenia is Associated With Oncological Prognosis and the Incidence of Secondary Cancer in Patients With Middle/Lower Rectal Cancer

Abe, Shinya; Nozawa, Hiroaki; Sasaki, Kazuhito; Murono, Koji; Emoto, Shigenobu; Yokoyama, Yuichiro; Matsuzaki, Hiroyuki; Nagai, Yoshinori; Yoshioka, Yuichiro; Shinagawa, Takahiro; Sonoda, Hirofumi; Ishihara, Soichiro

doi:10.1016/j.clcc.2022.10.001

Cited by 5 publications

(7 citation statements)

References 56 publications

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“…Thirteen studies explored the relationship between sarcopenia and OS among surgical rectal cancer patients [ 20 – 29 , 31 , 32 , 34 ]. The pooled results demonstrated that the presence of preoperative sarcopenia was significantly related to poor OS (hazard ratio (HR) = 2.07, 95% CI = 1.67–2.57, P<0.001; I 2 = 39.5%, P = 0.071) ( Fig 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis

Su,

Shen

2024

PLoS ONE

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Purpose To identify the predictive role of sarcopenia in long-term survival among rectal cancer patients who underwent surgery based on available evidence. Methods The Medline, EMBASE and Web of Science databases were searched up to October 20, 2023, for relevant studies. Overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were the endpoints. Hazard ratios (HRs) and 95% confidence intervals (CIs) were combined to evaluate the association between sarcopenia and survival. Results Fifteen studies with 4283 patients were included. The pooled results demonstrated that preoperative sarcopenia significantly predicted poorer OS (HR = 2.07, 95% CI = 1.67–2.57, P<0.001), DFS (HR = 1.85, 95% CI = 1.39–2.48, P<0.001) and CSS (HR = 1.83, 95% CI = 1.31–2.56, P<0.001). Furthermore, subgroup analysis based on neoadjuvant therapy indicated that sarcopenia was a risk factor for worse OS and DFS in patients who received (OS: HR = 2.44, P<0.001; DFS: HR = 2.16, P<0.001) but not in those who did not receive (OS: HR = 2.44, P<0.001; DDFS: HR = 1.86, P = 0.002) neoadjuvant chemoradiotherapy. In addition, subgroup analysis based on sample size and ethnicity showed similar results. Conclusion Preoperative sarcopenia is significantly related to poor survival in surgical rectal cancer patients and could serve as a novel and valuable predictor of long-term prognosis in these patients.

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Section: Resultsmentioning

confidence: 99%

“…Only four studies have explored the association between sarcopenia and postoperative CSS in rectal cancer patients [ 22 , 25 , 29 , 31 ]. The pooled results verified that preoperative sarcopenia also predicted worse CSS (hazard ratio (HR) = 1.83, 95% CI = 1.31–2.56, P<0.001; I 2 = 0.0%, P = 0.514) ( Fig 4 ).…”

Section: Resultsmentioning

confidence: 99%

Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis

Su,

Shen

2024

PLoS ONE

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“…Sarcopenia is a muscle wasting disease characterized by progressive loss of skeletal muscle mass, strength, and function, which will lead to increased odds of adverse clinical outcomes [23] . Abe et al believed that SA is an independent risk factor for overall survival and cancer specific survival in patients after radical resection of RC [24] . Deng et al found that RC patients with SA had poorer postoperative clinical outcomes and long-term prognosis compared to patients without SA [25] .…”

Section: Discussionmentioning

confidence: 99%

A Nomogram Combining Body Composition Analysis and Clinical Factors for Predicting the Prognosis of Patients with Resectable Rectal Cancer

Sun,

Bo,

Wang

et al. 2023

Preprint

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Objective To investigate the value of quantitative computed tomography (QCT) body composition parameters in assessing the prognosis of patients with resectable rectal cancer (RC). Methods A total of 94 patients with colorectal adenocarcinoma from 2016 to 2021 were retrospectively collected. All patients underwent QCT scan before operation. Skeletal muscle cross-sectional area, total fat area, subcutaneous fat area and visceral fat area were measured, and skeletal muscle index (SMI), total fat tissue index (TATI), subcutaneous fat index (SATI) and visceral fat index (VATI) were calculated. TATI, SATI, and VATI truncation values were obtained to predict postoperative outcomes in RC patients, and sarcopenia (SA) was evaluated by SMI. Results The cut off values of TATI, SATI, and VATI were 106.39 cm /m , 47.33 cm /m , and 42.61 cm /m . The overall incidence of SA was 30.0% (28/94). Tumor N-stage, SA, and VATI were independent risk factors for postoperative outcomes in RC patients ( P < 0.05). The AUC of the nomogram model was 0.844 (95% CI: 0.755 - 0.911). Conclusion Tumor N-stage, SA, and VATI correlated with prognosis in RC patients undergoing surgery. The nomogram model established in this study has some value for evaluating the prognosis of patients with resectable RC.

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“…Hamaguchi et al 22 reported the validity of applying PMI to define sarcopenia in Asian populations, and accumulating numbers of reports have shown its validity as an indicator of sarcopenia and have shown the association with colorectal cancer prognosis. [23][24][25][26][27] Based on such evidence, PMI was applied as an indicator of sarcopenia in this Asian population study. The total psoas muscle area was identified and quantified in HU using the OsiriX DICOM Viewer (Pixmeo SARL, Switzerland) to measure pixels with a window width of -30 to 150 HU to delineate the muscle compartments and compute the cross-sectional area of each in centimeters squared (cm 2 ).…”

Section: Definition Of Sarcopeniamentioning

confidence: 99%

The Prognostic Impact of Preoperative Osteopenia in Patients with Colorectal Cancer

Kato,

Seishima,

Mizuno

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Osteopenia, a condition in which bone mineral density is lower than normal, is a noted risk factor that leads to a shortened healthy life expectancy. OBJECTIVE: This study aimed to investigate the prognostic impact of preoperative osteopenia in colorectal cancer patients. DESIGN: This was a retrospective study. SETTING: This study was conducted at a university hospital. PATIENTS: A total of 1,086 stage I-III colorectal cancer patients who underwent curative resection. MAIN OUTCOME MEASURES: Osteopenia was evaluated with computed tomography imaging. Overall survival, disease-specific survival, and recurrence-free survival were the primary endpoints. RESULTS: Osteopenia was identified in 300 patients (27.6%). Compared with the non-osteopenia group, the 5-year overall survival (74.0% vs. 93.4%, p < 0.001), disease-specific survival (81.6% vs. 97.2%, p < 0.001), and recurrence-free survival rates (57.1% vs. 88.3%, p < 0.001) were significantly lower in the osteopenia group. Multivariate analyses showed that preoperative osteopenia was significantly associated with worse overall survival (HR: 4.135; 95% CI: 2.963-5.770; p < 0.001), disease-specific survival (HR: 7.673; 95% CI: 4.646-12.675; p < 0.001), and recurrence-free survival (HR: 5.039; 95% CI: 3.811-6.662; p < 0.001). The prognosis of the osteopenia group was poorer than that of the non-osteopenia group in every stage: 5-year overall survival (stage I: 89.4% vs. 96.9%, p = 0.028; stage II: 76.5% vs. 91.9%, p < 0.001; stage III: 56.4% vs. 90.8%, p < 0.001) and 5-year RFS (stage I: 85.4% vs. 96.6%, p = 0.002; stage II: 62.0% vs. 86.5%, p < 0.001; stage III: 26.4% vs. 80.0%, p < 0.001). LIMITATIONS: The main limitations are retrospective single-institutional feature, and races of study population. CONCLUSION: Preoperative osteopenia could be a strong predictive marker for long-term prognosis in colorectal cancer regardless of stage.

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Sarcopenia is Associated With Oncological Prognosis and the Incidence of Secondary Cancer in Patients With Middle/Lower Rectal Cancer

Cited by 5 publications

References 56 publications

Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis

Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis

A Nomogram Combining Body Composition Analysis and Clinical Factors for Predicting the Prognosis of Patients with Resectable Rectal Cancer

The Prognostic Impact of Preoperative Osteopenia in Patients with Colorectal Cancer

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