Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan,
Digestion. 2019;99(1):79-85. doi: 10.1159/000494417. Epub 2018 Dec 14.
Regorafenib and TAS-102 are standard salvage-line treatment options for patients with chemorefractory metastatic colorectal cancer (mCRC). We aimed to evaluate the prognostic significance of skeletal muscle mass in mCRC patients receiving these salvage-line therapies.
We conducted a retrospective analysis of 52 patients with mCRC who received regorafenib or TAS-102 as salvage-line treatment. Skeletal muscle cross-sectional area was measured by pretreatment CT to obtain the skeletal muscle index (SMI, cm2/m2). We divided patients into 2 groups (low-SM/high-SMI) based on the median value of SMI.
The median SMI was 51.8 cm2/m2 in males and 39.2 cm2/m2 in females. In Kaplan-Meier analysis, patients in the low-SMI group showed significantly shorter overall survival (3.7 vs. 7.3 months, log-rank p = 0.002) and progression-free survival (1.9 vs. 2.8 months, log-rank test p = 0.009) than those in the high-SMI group. Subsequent multivariate analysis revealed that the SMI was an independent prognostic factor (hazard ratio = 2.381, 95% CI 1.189-4.944, p = 0.014). Patients in the low-SMI group had significantly more grade 3 or 4 adverse events than those in the high-SMI group (46 vs.12%, p = 0.013).
Low skeletal muscle mass is a negative factor for survival outcomes in mCRC patients treated with salvage-line chemotherapy.
瑞戈非尼和 TAS-102 是化疗耐药转移性结直肠癌（mCRC）患者的标准二线治疗选择。我们旨在评估这些二线治疗中骨骼肌质量对 mCRC 患者的预后意义。
我们对接受瑞戈非尼或 TAS-102 二线治疗的 52 例 mCRC 患者进行了回顾性分析。采用预处理 CT 测量骨骼肌横截面积，以获得骨骼肌指数（SMI，cm2/m2）。我们根据 SMI 的中位数将患者分为两组（低-SMI/高-SMI）。
男性 SMI 的中位数为 51.8 cm2/m2，女性为 39.2 cm2/m2。在 Kaplan-Meier 分析中，低-SMI 组患者的总生存期（3.7 个月与 7.3 个月，对数秩检验 p = 0.002）和无进展生存期（1.9 个月与 2.8 个月，对数秩检验 p = 0.009）均显著短于高-SMI 组。随后的多因素分析显示，SMI 是独立的预后因素（危险比=2.381，95%CI 1.189-4.944，p = 0.014）。低-SMI 组患者的 3 级或 4 级不良事件发生率明显高于高-SMI 组（46%与 12%，p = 0.013）。
低骨骼肌质量是接受二线化疗的 mCRC 患者生存结局的负面因素。
