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Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival.
AJR Am J Roentgenol. 2018 Mar; 210(3):526-532.AA

Abstract

OBJECTIVE

The purpose of this study was to evaluate the relationship between sarcopenia and overall and progression-free survival in patients with colorectal cancer.

MATERIALS AND METHODS

This study was retrospective and complied with HIPAA. Patients with colorectal cancer who underwent CT at the time of and 6-18 months after diagnosis were included. Patients were followed for at least 5 years after diagnosis. Skeletal muscle index (SMI) and mean muscle attenuation of the psoas and paraspinal muscles at the L4 level determined the degree of sarcopenia. Composite measurements combining psoas and paraspinal muscles (total muscle) were also obtained. Univariate and multivariate Cox proportional hazard analysis was performed to evaluate the association between survival and changes in SMI and changes in attenuation. Kaplan-Meier analysis was also performed.

RESULTS

A total of 101 patients were included (mean age ± SD, 63.7 ± 13.7 years; 68 men, 33 women). The hazard ratios for overall survival were 2.27, 1.68, and 1.54 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (all p < 0.05). The hazard ratios for overall survival were 1.14, 1.18, and 1.24 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (all p < 0.05). The hazard ratios for progression-free survival were 1.33, 1.41, and 1.23 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (not statistically significant). The hazard ratios for progression-free survival were 1.10, 1.21, and 1.23 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (p < 0.05). Kaplan-Meier analysis showed significant differences in overall and progression-free survival based on sex-specific quartiles of muscle quantity and quality.

CONCLUSION

Progressive sarcopenia after diagnosis of colorectal cancer has a significant negative prognostic association with overall and progression-free survival.

Authors+Show Affiliations

1 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Linkou, Taiwan.2 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung, Taiwan. 3 Keelung Osteoporosis Prevention and Treatment Center, Keelung, Taiwan.4 Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.1 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Linkou, Taiwan.5 Division of Colorectal Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Keelung, Taiwan.6 Department of Internal Medicine, Division of Hematooncology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, 222 Maijin Rd, Keelung, Taiwan.4 Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29364725

Citation

Deng, Chih-Ying, et al. "Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival." AJR. American Journal of Roentgenology, vol. 210, no. 3, 2018, pp. 526-532.
Deng CY, Lin YC, Wu JS, et al. Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival. AJR Am J Roentgenol. 2018;210(3):526-532.
Deng, C. Y., Lin, Y. C., Wu, J. S., Cheung, Y. C., Fan, C. W., Yeh, K. Y., & McMahon, C. J. (2018). Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival. AJR. American Journal of Roentgenology, 210(3), 526-532. https://doi.org/10.2214/AJR.17.18020
Deng CY, et al. Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival. AJR Am J Roentgenol. 2018;210(3):526-532. PubMed PMID: 29364725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progressive Sarcopenia in Patients With Colorectal Cancer Predicts Survival. AU - Deng,Chih-Ying, AU - Lin,Yu-Ching, AU - Wu,Jim S, AU - Cheung,Yun-Chung, AU - Fan,Chung-Wei, AU - Yeh,Kun-Yun, AU - McMahon,Colm J, Y1 - 2018/01/24/ PY - 2018/1/25/pubmed PY - 2018/11/9/medline PY - 2018/1/25/entrez KW - colorectal cancer KW - sarcopenia KW - survival SP - 526 EP - 532 JF - AJR. American journal of roentgenology JO - AJR Am J Roentgenol VL - 210 IS - 3 N2 - OBJECTIVE: The purpose of this study was to evaluate the relationship between sarcopenia and overall and progression-free survival in patients with colorectal cancer. MATERIALS AND METHODS: This study was retrospective and complied with HIPAA. Patients with colorectal cancer who underwent CT at the time of and 6-18 months after diagnosis were included. Patients were followed for at least 5 years after diagnosis. Skeletal muscle index (SMI) and mean muscle attenuation of the psoas and paraspinal muscles at the L4 level determined the degree of sarcopenia. Composite measurements combining psoas and paraspinal muscles (total muscle) were also obtained. Univariate and multivariate Cox proportional hazard analysis was performed to evaluate the association between survival and changes in SMI and changes in attenuation. Kaplan-Meier analysis was also performed. RESULTS: A total of 101 patients were included (mean age ± SD, 63.7 ± 13.7 years; 68 men, 33 women). The hazard ratios for overall survival were 2.27, 1.68, and 1.54 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (all p < 0.05). The hazard ratios for overall survival were 1.14, 1.18, and 1.24 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (all p < 0.05). The hazard ratios for progression-free survival were 1.33, 1.41, and 1.23 for changes in SMI of the psoas muscle, paraspinal muscle, and total muscle (not statistically significant). The hazard ratios for progression-free survival were 1.10, 1.21, and 1.23 for changes in attenuation of the psoas muscle, paraspinal muscle, and total muscle, respectively (p < 0.05). Kaplan-Meier analysis showed significant differences in overall and progression-free survival based on sex-specific quartiles of muscle quantity and quality. CONCLUSION: Progressive sarcopenia after diagnosis of colorectal cancer has a significant negative prognostic association with overall and progression-free survival. SN - 1546-3141 UR - https://www.unboundmedicine.com/medline/citation/29364725/Progressive_Sarcopenia_in_Patients_With_Colorectal_Cancer_Predicts_Survival_ L2 - https://www.ajronline.org/doi/10.2214/AJR.17.18020 DB - PRIME DP - Unbound Medicine ER -