The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: A systematic review

Malietzis, George; Aziz, Omer; Bagnall, Nigel Mark; Johns, Neil; Fearon, Kenneth C. H.; Jenkins, John T.

doi:10.1016/j.ejso.2014.10.056

Cited by 141 publications

(131 citation statements)

References 58 publications

(98 reference statements)

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“…Host-related factors, in particular the body composition profile, also appear to be important. There is evolving evidence that body composition parameters such as the presence of obesity or muscle depletion may influence outcomes in patients with primary operable colorectal cancer 4 . This appears to be independent of TNM stage and other high-risk pathological features.…”

Section: Introductionmentioning

confidence: 99%

Influence of body composition profile on outcomes following colorectal cancer surgery

Malietzis

Currie

Athanasiou

et al. 2016

British Journal of Surgery

227

224

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Section: Introductionmentioning

confidence: 99%

Influence of body composition profile on outcomes following colorectal cancer surgery

Malietzis

Currie

Athanasiou

et al. 2016

British Journal of Surgery

227

224

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“…Accumulating evidence, including from the C‐SCANS cohort from which our study sample was derived,15 testifies to the importance of skeletal muscle in cancer survival 9, 15, 16, 17 and to the benefits of building and maintaining muscle throughout the cancer trajectory 1, 34, 35, 36, 37, 38. While standard methods for assessing muscle (e.g.…”

Section: Discussionmentioning

confidence: 86%

“…Low skeletal muscle mass is common among cancer patients1, 2 and predicts surgical complications,3, 4, 5, 6, 7, 8, 9 treatment toxicity,10, 11, 12, 13, 14 poor quality of life, and reduced survival 9, 15, 16, 17. This accumulating evidence has prompted oncologists to identify skeletal muscle mass as an important biomarker for numerous adverse outcomes in cancer patients 18.…”

Section: Introductionmentioning

confidence: 99%

Screening for low muscularity in colorectal cancer patients: a valid, clinic‐friendly approach that predicts mortality

Feliciano

Avrutin

Caan

et al. 2018

J cachexia sarcopenia muscle

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BackgroundLow skeletal muscle quantified using computed tomography (CT) scans is associated with morbidity and mortality among cancer patients. However, existing methods to assess skeletal muscle from CT are time‐consuming, expensive, and require training. Clinic‐friendly tools to screen for low skeletal muscle in cancer patients are urgently needed.MethodsWe included 807 scans from non‐metastatic colorectal cancer patients. With the digital ruler available in most radiological software, we implemented an abbreviated method to assess skeletal muscle area at the third lumbar vertebra (L3), which consisted of assessing the height and width of the psoas and paraspinal muscles and computing their combined ‘linear area’ in centimetres squared (cm2). A subset of CT scans was assessed twice by two analysts to compute intra‐rater and inter‐rater reliability. We derived cut‐points for ‘low’ linear area using optimal stratification and then calculated the sensitivity and specificity of these cut‐points relative to standard methods (total L3 cross‐sectional area assessed with Slice‐O‐Matic research software). We further evaluated the association of low linear area with death from any cause after colorectal cancer diagnosis in Cox proportional hazards models adjusting for demographics, smoking, body mass index category, and tumour characteristics.ResultsThe linear area was highly correlated with total cross‐sectional area assessed using standard methods [r = 0.92; 95% confidence interval (CI): 0.91, 0.93] overall and within subgroups defined by age, sex, and body mass index group. Intra‐rater and inter‐rater reliability were equally high (both intra‐class correlations = 0.98). Cut‐points for low linear area were sensitive (0.75; 95% CI: 0.70, 0.80) and specific (0.77; 95% CI: 0.73, 0.80) for identifying low skeletal muscle relative to the standard of total L3 cross‐sectional area. The hazard ratio and 95% CI for death associated with a low linear area were hazard ratio = 1.66; 95% CI: 1.22, 2.25.ConclusionsClinic‐friendly methods that assess linear area from CT scans are an accurate screening tool to identify low skeletal muscle among non‐metastatic colorectal cancer patients. These linear measures are associated with mortality after colorectal cancer, suggesting they could be clinically useful both to improve prognostication and to provide a practical screening tool to identify cancer patients who require nutrition or exercise intervention.

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“…The measurement, considered an excellent method, is made at L3 level, provides total, visceral or subcutaneous adipose (fat) area (TFA, VFA, SFA), total psoas area (TPA), visceral adipose vol- ume (VFV) and skeletal muscle index (SMI) [22]. Moreover CTCB has been used to derive an predictive cardio-metabolic risk equation, after a large triethnic sample, according to ethnicity-and sex-specific data [23].…”

Section: Computed Tomography (Ct) and Ct Body Composition (Ctbc)mentioning

confidence: 99%

Body composition in clinical practice

Andréoli

Garaci

Cafarelli

et al. 2016

European Journal of Radiology

160

108

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a b s t r a c tNutritional status is the results of nutrients intake, absorption and utilization, able to influence physiological and pathological conditions. Nutritional status can be measured for individuals with different techniques, such as CT Body Composition, quantitative Magnetic Resonance Imaging, Ultrasound, DualEnergy X-Ray Absorptiometry and Bioimpendance. Because obesity is becoming a worldwide epidemic, there is an increasing interest in the study of body composition to monitor conditions and delay in development of obesity-related diseases. The emergence of these evidence demonstrates the need of standard assessment of nutritional status based on body weight changes, playing an important role in several clinical setting, such as in quantitative measurement of tissues and their fluctuations in body composition, in survival rate, in pathologic condition and illnesses. Since body mass index has been shown to be an imprecise measurement of fat-free and fat mass, body cell mass and fluids, providing no information if weight changes, consequently there is the need to find a better way to evaluate body composition, in order to assess fat-free and fat mass with weight gain and loss, and during ageing. Monitoring body composition can be very useful for nutritional and medical interventional. This review is focused on the use of Body Composition in Clinical Practice.

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The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: A systematic review

Cited by 141 publications

References 58 publications

Influence of body composition profile on outcomes following colorectal cancer surgery

Influence of body composition profile on outcomes following colorectal cancer surgery

Screening for low muscularity in colorectal cancer patients: a valid, clinic‐friendly approach that predicts mortality

Body composition in clinical practice

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