The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I–III colorectal cancer: a population‐based cohort study (C‐SCANS)

Abstract

BackgroundMuscle abnormalities such as low muscle mass and low muscle radiodensity are well known risk factors for unfavourable cancer prognosis. However, little is known in regard to the degree and impact of longitudinal changes in muscle mass and radiodensity within the context of cancer. Here, we explore the relationship between muscle wasting and mortality in a large population‐based study of patients with non‐metastatic colorectal cancer (CRC).MethodsA total of 1924 patients with stage I–III CRC who underwent surgical resection in the Kaiser Permanente Northern California Health System were included. Muscle mass and radiodensity were quantified using computed tomography images obtained at diagnosis and after approximately 14 months. Cox proportional‐hazards models were used to estimate hazard ratios for all‐cause mortality.ResultsThe hazard ratio for all‐cause mortality among patients with the largest deterioration in muscle mass (≥2 SD; ≥11.4% loss from baseline), as compared with those who remained stable (±1 SD; 0.0 ± 5.7%) was 2.15 [95% confidence interval (CI): 1.59–2.92; P < 0.001]. The hazard ratio for all‐cause mortality among patients who experienced the largest deterioration in muscle radiodensity (≥2 SD; ≥20.2% loss from baseline), as compared with those who remained stable (±1 SD; 0.0 ± 10.1%) was 1.61 (95% CI: 1.20–2.15; P = 0.002).ConclusionsIn patients with stage I–III CRC, muscle wasting is a risk factor for mortality, independent of change in body mass and other body composition parameters.

Single‐institution study of correlations between skeletal muscle mass, its density, and clinical outcomes in non‐small cell lung cancer patients treated with first‐line chemotherapy

“…Regarding the prognostic value of skeletal muscle radiodensity (SMD), only one study by Sjoblom et al . showed that SMD had a statistically significant negative prognostic value in non‐small cell lung cancer (NSCLC) patients, 15 a finding also reported in other types of tumors …”

Muscle radiodensity loss during cancer therapy is predictive for poor survival in advanced endometrial cancer

“…Evaluating muscle at a single specific time point may not help in predicting survival and could not evaluate muscle loss . These findings suggested that a longitudinal study of changes in body composition may provide a more comprehensive understanding of the impacts of body composition on outcomes …”

“…49,62 These findings suggested that a longitudinal study of changes in body composition may provide a more comprehensive understanding of the impacts of body composition on outcomes. [40][41][42][43][44][45][46][47][48][49] Body mass index is an imprecise measure of body composition, and monitoring BMI changes may be insufficient to promptly identify occult body composition changes. 18,19 We found that changes in SMI and TATI were weakly correlated with the change in BMI, and changes in SMD and SMG showed no correlation with the BMI.…”

“…[35][36][37] Sarcopenia and myosteatosis at the time of cancer diagnosis were previously shown to be associated with the outcome in EC. 38,39 A longitudinal study of changes in body composition during cancer therapy may provide a more comprehensive understanding of the influences of body composition on cancer outcomes [40][41][42][43][44][45][46][47][48][49][50][51] ; however, the changes in body composition during cancer therapy and its impact on outcomes in stage III EC patients were unclear. Moreover, current doses of chemotherapy are calculated based on body surface area (BSA), which takes only height and weight into account and not other potentially important body composition parameters.…”

Low Skeletal Muscle Mass before Salvage-Line Chemotherapy Is a Poor Prognostic Factor in Patients with Refractory Metastatic Colorectal Cancer

“…The first is its small sample size and the retrospective design. In addition, we were not able to measure the skeletal muscle density, which has been reported to be a useful prognostic factor in patients with various cancer types [21,22].…”