Department of Surgery, San Raffaele Scientific Institute, Milan, Italy.
Department of Surgery, San Raffaele Scientific Institute, Milan, Italy.
Curr Probl Cancer. 2020 Apr;44(2):100510. doi: 10.1016/j.currproblcancer.2019.100510. Epub 2019 Nov 1.
To establish the correlation between changes in body composition after neoadjuvant chemoradiotherapy (nCRT) and postoperative outcomes, in patients with advanced low rectal cancer.
Patients with clinical stage T≥3 or N+ rectal cancer who underwent nCRT and surgical resection were studied. Skeletal muscle, visceral, and subcutaneous fat cross-sectional area were measured by computed tomography before and after nCRT. Postoperative morbidity, pathologic response to nCRT, overall and disease-free survival was assessed.
Fifty-two patients, median age 62 (range 32-79) were studied. A skeletal muscle loss >2% significantly correlated with a shorter disease-free survival both in the overall population (P = 0.048) and in the subgroup of N0 patients (P = 0.048). A subcutaneous fat loss >5% was also associated with a shorter disease-free survival (P = 0.012) in the whole population.
Skeletal muscle loss, after neoadjuvant chemoradiotherapy, negatively impacts on disease-free survival in surgically treated rectal cancer patients.
探讨新辅助放化疗（nCRT）后体成分变化与局部进展期低位直肠癌患者术后结局的相关性。
本研究纳入了接受 nCRT 联合手术治疗的临床 T 分期≥3 或 N+的直肠癌患者。通过 CT 测量 nCRT 前后的骨骼肌、内脏和皮下脂肪的横截面积。评估术后并发症、nCRT 的病理反应、总生存和无病生存情况。
共纳入 52 例患者，中位年龄为 62 岁（范围 32-79 岁）。骨骼肌丢失>2%与总人群（P=0.048）和 N0 患者亚组（P=0.048）的无病生存时间较短显著相关。在全人群中，皮下脂肪丢失>5%也与无病生存时间较短相关（P=0.012）。
新辅助放化疗后骨骼肌丢失与接受手术治疗的直肠癌患者的无病生存时间负相关。
