Prognostic value of adipose tissue and muscle mass in advanced colorectal cancer: a post hoc analysis of two non-randomized phase II trials

BMC Cancer

Marianne Paesmans¹  Lieveke Ameye²  Caroline Vandeputte³  Gauthier Demolin⁴  Nicolas Charette⁵  Jean-Luc Van Laethem⁶  Jonathan Krygier⁷  Camille Van Bogaert⁷  Amélie Deleporte⁷  Alain Hendlisz⁷  Patrick Flamen⁸  Thomas Guiot⁸  Stéphane Holbrechts⁹  Thierry Delaunoit^1,10  Marc Peeters^1,11  Karen Geboes^1,12 

[1] Data centre, Institut Jules Bordet - Université Libre de Bruxelles (ULB);Data centre, Institut Jules Bordet, Université Libre de Bruxelles (ULB);Gastro-Oncology translational laboratory, Institut Jules Bordet - Université Libre de Bruxelles (ULB);Gastroenterology Department, Centre Hospitalier Chrétien St-Joseph;Gastroenterology Department, Hôpital Civil Marie Curie;Gastroenterology Medico-Surgical Department, Erasme University Hospital, Université Libre de Bruxelles (ULB);Medical Oncology Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB);Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB);Oncology Department, CHU Ambroise Paré;Oncology department, Hôpital de Jolimont;Oncology department, Universitair Ziekenhuis Antwerpen;Service of digestive oncology, Universitair Ziekenhuis Gent;

关键词: Colorectal cancer;    Prognosis;    Chemotherapy;    Sarcopenia;    Myosteatosis;    Obesity;   

DOI  :  10.1186/s12885-019-5319-8

来源: DOAJ

【 摘 要 】

Abstract Background The prognostic value of body composition in cancer patients has been widely studied during the last decade. The main finding of these studies is that sarcopenia, or skeletal muscle depletion, assessed by CT imaging correlates with a reduced overall survival (OS). By contrast, the prognostic value of fat mass remains ill-defined. This study aims to analyze the influence of body composition including both muscle mass and adipose tissue on OS in a homogeneous population of advanced colorectal cancer (CRC) patients. Methods Among 235 patients with chemorefractory advanced CRC included in the SoMore and RegARd-C trials, body composition was assessed in 217 patients on baseline CT images. The relationship between body composition (sarcopenia, muscle density, subcutaneous and visceral fat index and density), body mass index (BMI) and OS were evaluated. Results Patients with a higher BMI had a better OS (≥30 versus < 30, HR: 0.50; 0.33–0.76). Those with low muscle index and muscle density had an increased mortality (HR: 2.06; 1.45–2.93 and HR: 1.54; 1.09–2.18, respectively). Likewise, low subcutaneous and visceral fat index were associated with an increased risk of dying (HR: 1.63; 1.23–2.17 and 1.48; 1.09–2.02 respectively), as were a high subcutaneous and visceral adipose tissue density (HR: 1.93; 1.44–2.57 and 2.40; 1.79–3.20 respectively). In multivariate analysis, a high visceral fat density was the main predictor of poor survival. Conclusions Our results confirm the protective role of obesity in CRC patients at an advanced stage, as well as the negative prognostic impact of muscle depletion on survival. More importantly, our data show for the first time that visceral adipose tissue density is an important prognostic factor in metastatic CRC. Trial registration NCT01290926, 07/02/2011 and NCT01929616, 28/08/2013.

【 授权许可】

Unknown