Lin Wen-Li, Wu Li-Min, Huang Wen-Tsung, Guo How-Ran, Chen Jyh-Jou
Center for Quality Management, Chi Mei Hospital, Liouying, Tainan, Taiwan.
School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Surg Oncol. 2023 Dec;128(7):1121-1132. doi: 10.1002/jso.27405. Epub 2023 Aug 17.
Studies have been conducted to evaluate whether sarcopenia is a predictor for survival in patients with colon cancer postsurgery, but findings have been inconsistent, and effects of age were seldom evaluated.
We recruited 133 patients with resectable colon cancer who underwent surgery between January 2014 and December 2017 at a teaching hospital to evaluate the effects of sarcopenia on survival, after adjusting for age and other potential predictors, including visceral adiposity (VA).
Preoperative sarcopenia was associated with worse overall survival (OS: 62.3% vs. 83.8%, p = 0.04) and longer hospital stay (20.6 vs. 14.9 days, p < 0.01) while VA was not. Cox proportional hazards regressions showed that sarcopenia was associated with an adjusted hazard ratio (HR) of 2.91 (95% confidence interval [CI]: 1.08-7.86) after adjustment for other independent risk factors, but was not associated with disease free survival. In stratified analyses, we found that sarcopenia was an independent factor for worse OS (adjusted HR = 1.94; 95% CI: 1.11-3.38) among patients >70 years, but not among patients ≤70 years (HR = 0.48; 95% CI: 0.55-4.55).
Age appeared to be a modifier of the effects of sarcopenia on OS among colon cancer patients postsurgery.
已有研究评估肌肉减少症是否为结肠癌术后患者生存的预测指标,但结果并不一致,且很少评估年龄的影响。
我们招募了133例2014年1月至2017年12月在一家教学医院接受手术的可切除结肠癌患者,在调整年龄和其他潜在预测因素(包括内脏脂肪量(VA))后,评估肌肉减少症对生存的影响。
术前肌肉减少症与较差的总生存期(OS:62.3%对83.8%,p = 0.04)和更长的住院时间(20.6天对14.9天,p < 0.01)相关,而VA则不然。Cox比例风险回归显示,在调整其他独立危险因素后,肌肉减少症的调整后风险比(HR)为2.91(95%置信区间[CI]:1.08 - 7.86),但与无病生存期无关。在分层分析中,我们发现肌肉减少症是70岁以上患者较差OS的独立因素(调整后HR = 1.94;95% CI:1.11 - 3.38),但在70岁及以下患者中并非如此(HR = 0.48;95% CI:0.55 - 4.55)。
年龄似乎是肌肉减少症对结肠癌术后患者OS影响的一个调节因素。