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CT 定量体成分与非转移性结直肠癌患者术后定期化疗后复发和生存的关系。

Association between CT-Quantified Body Composition and Recurrence, Survival in Nonmetastasis Colorectal Cancer Patients Underwent Regular Chemotherapy after Surgery.

机构信息

Department of Pneumology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Biomed Res Int. 2021 Mar 25;2021:6657566. doi: 10.1155/2021/6657566. eCollection 2021.

Abstract

BACKGROUND

Body mass index, measured at colorectal cancer (CRC) diagnosis has been associated with recurrence and survival outcomes. Computed tomography- (CT-) defined body compositions accurately reflect body mass, but there was no consistent perspective on the influence of visceral adipose tissue (VAT) and skeletal muscle mass (SM) on the prognosis of nonmetastasis CRC, especially in the patients underwent surgery and regularly standard chemotherapy.

METHODS

We investigated the associations of CT-quantified body composition (VAT and SM) with CRC patients successively underwent surgery and regular 8-12 of periods standard chemotherapy. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body compositions was analyzed using the Cox regression model, and precise clinical nomograms were established.

RESULTS

In XELOX-treated patients, progression-free survival (PFS) ( = 0.025) and overall survival (OS) ( = 0.032) were lower in the high-SM than in the low-SM group. The univariate analysis demonstrated that compared with low-SM patients, patients with high-SM showed a strikingly poor prognosis in both OS ( = 0.0512) and PFS in the T4 subgroup ( = 0.0417), while contrary to the T2-3 subgroup.

CONCLUSIONS

CT-quantified body compositions have a significant influence on CRC patients successively underwent curative resection and regularly standard chemotherapy with the endpoints of 1-year, 3-year, and 5-year both OS and PFS. Patients with high-SM showed a strikingly poor prognosis in OS and PFS in the T4 subgroup; however, the prognosis role of body composition was opposite in T2-3 patients.

摘要

背景

结直肠癌(CRC)诊断时的体重指数与复发和生存结果有关。计算机断层扫描(CT)定义的身体成分准确反映体重,但关于内脏脂肪组织(VAT)和骨骼肌质量(SM)对非转移性 CRC 预后的影响,尚无一致的观点,特别是在接受手术和定期标准化疗的患者中。

方法

我们研究了 CT 定量的身体成分(VAT 和 SM)与连续接受手术和定期 8-12 个周期标准化疗的 CRC 患者的相关性。所有 CT 图像均在 L3/4 脊柱水平获得。使用 Cox 回归模型分析身体成分的预后价值,并建立精确的临床列线图。

结果

在 XELOX 治疗的患者中,高 SM 组的无进展生存期(PFS)(= 0.025)和总生存期(OS)(= 0.032)较低。单因素分析表明,与低 SM 患者相比,高 SM 患者在 OS(= 0.0512)和 T4 亚组的 PFS(= 0.0417)中均显示出明显较差的预后,而在 T2-3 亚组中则相反。

结论

CT 定量的身体成分对连续接受根治性切除术和定期标准化疗的 CRC 患者具有重要影响,以 1 年、3 年和 5 年的 OS 和 PFS 为终点。高 SM 患者在 T4 亚组中的 OS 和 PFS 中预后较差;然而,在 T2-3 患者中,身体成分的预后作用相反。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcad/8016588/986a07144676/BMRI2021-6657566.001.jpg

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