Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile.
ANZ J Surg. 2021 May;91(5):E298-E306. doi: 10.1111/ans.16708. Epub 2021 Mar 7.
There is an increasing interest in studying the impact of altered body composition parameters and colorectal cancer (CRC) treatment outcomes. The aim of this study is to explore the impact of computed tomography (CT)-measured visceral obesity, sarcopenia and myosteatosis on survival of non-metastatic CRC.
Consecutive patients with stage I-III CRC who underwent curative-intent treatment between January 2010 and December 2015 were included. By measuring the visceral fat area, and the skeletal muscle index and radiodensity in the pre-operative staging CT, patients were classified as visceral obese, sarcopenic or myosteatotic. The associations between CT-based body composition parameters and survival were assessed using log-rank tests and a Cox regression analysis.
Of 359 patients, 263 (73.3%) were visceral obese, 85 (23.7%) sarcopenic and 80 (22.3%) myosteatotic. Overall (OS), cancer-specific (CSS) and disease-free survivals (DFS) at 5 years were 78.8%, 84.7% and 75%, respectively. Myosteatosis and the combination of myosteatosis and visceral obesity were associated with a reduced DFS (hazard ratio 1.67; 95% confidence interval 1.06-2.61 and hazard ratio 1.85; 95% confidence interval 1.15-2.96, respectively). However, after performing a multivariate analysis including other relevant clinicopathological factors, none of the body composition parameters were associated with any long-term outcome measures, even after stratifying by cancer stage.
CT-measured body composition parameters do not independently influence survival in non-metastatic CRC. There is a need for larger cohort studies with standardized patient selection and methodology to confirm these findings.
人们对研究改变的身体成分参数和结直肠癌（CRC）治疗结果的影响越来越感兴趣。本研究旨在探讨 CT 测量的内脏肥胖、肌肉减少症和肌脂过多症对非转移性 CRC 患者生存的影响。
纳入 2010 年 1 月至 2015 年 12 月期间接受根治性治疗的 I-III 期 CRC 连续患者。通过在术前分期 CT 上测量内脏脂肪面积以及骨骼肌指数和放射密度，将患者分为内脏肥胖、肌肉减少症或肌脂过多症。使用对数秩检验和 Cox 回归分析评估 CT 基于身体成分参数与生存之间的关联。
在 359 名患者中，263 名（73.3%）为内脏肥胖，85 名（23.7%）为肌肉减少症，80 名（22.3%）为肌脂过多症。5 年总体生存率（OS）、癌症特异性生存率（CSS）和无病生存率（DFS）分别为 78.8%、84.7%和 75%。肌脂过多症和肌脂过多症与内脏肥胖的联合与 DFS 降低相关（风险比 1.67；95%置信区间 1.06-2.61 和风险比 1.85；95%置信区间 1.15-2.96）。然而，在进行包括其他相关临床病理因素的多变量分析后，即使在按癌症分期分层后，也没有身体成分参数与任何长期预后指标相关。
CT 测量的身体成分参数不会独立影响非转移性 CRC 的生存。需要进行更大的队列研究，以标准化患者选择和方法，以证实这些发现。
