Muscle Loss Is Associated with Overall Survival in Patients with Metastatic Colorectal Cancer Independent of Tumor Mutational Status and Weight Loss

The oncologist

article

Till Dominik Best¹  J. Peter Marquardt²  Christopher P. Bridge⁴  Jennifer S. Temel⁵  Ryan B. Corcoran⁵  Ryan D. Nipp⁵  Florian J. Fintelmann²  Eric J. Roeland⁵  Nora K. Horick⁶  Emily E. Van Seventer⁵  Areej El-Jawahri⁵  Amelie S. Troschel²  Patrick C. Johnson⁵  Katie N. Kanter⁵  Madeleine G. Fish⁵ 

[1] Department of Radiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health;Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital & Harvard Medical School;School of Medicine, RWTH Aachen University;MGH and BWH Center for Clinical Data Science;Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center & Harvard Medical School;Department of Statistics, Massachusetts General Hospital & Harvard Medical School

关键词: Body composition;    Skeletal muscle;    Sarcopenia;    Colorectal cancer;    Survival;    Outcomes;   

DOI  :  10.1002/onco.13774

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Survival in patients with metastatic colorectal cancer (mCRC) has been associated with tumor mutational status, muscle loss, and weight loss. We sought to explore the combined effects of these variables on overall survival. Materials and Methods We performed an observational cohort study, prospectively enrolling patients receiving chemotherapy for mCRC. We retrospectively assessed changes in muscle (using computed tomography) and weight, each dichotomized as >5% or ≤5% loss, at 3, 6, and 12 months after diagnosis of mCRC. We used regression models to assess relationships between tumor mutational status, muscle loss, weight loss, and overall survival. Additionally, we evaluated associations between muscle loss, weight loss, and tumor mutational status. Results We included 226 patients (mean age 59 ± 13 years, 53% male). Tumor mutational status included 44% wild type, 42% RAS-mutant, and 14% BRAF-mutant . Patients with >5% muscle loss at 3 and 12 months experienced worse survival controlling for mutational status and weight (3 months hazard ratio, 2.66; p 5% muscle loss with BRAF -mutational status at 6 and 12 months. Weight loss was not associated with survival nor mutational status. Conclusion Increased muscle loss at 3 and 12 months may identify patients with mCRC at risk for decreased overall survival, independent of tumor mutational status. Specifically, >5% muscle loss identifies patients within each category of tumor mutational status with decreased overall survival in our sample. Our findings suggest that quantifying muscle loss on serial computed tomography scans may refine survival estimates in patients with mCRC. Implications for Practice In this study of 226 patients with metastatic colorectal cancer, it was found that losing >5% skeletal muscle at 3 and 12 months after the diagnosis of metastatic disease was associated with worse overall survival, independent of tumor mutational status and weight loss. Interestingly, results did not show a significant association between weight loss and overall survival. These findings suggest that muscle quantification on serial computed tomography may refine survival estimates in patients with metastatic colorectal cancer beyond mutational status.

【 授权许可】

CC BY|CC BY-NC