Prognostic value of adipose tissue and muscle mass in advanced colorectal cancer: a post hoc analysis of two non-randomized phase II trials.
Adipose Tissue
/ pathology
Adult
Aged
Aged, 80 and over
Biomarkers
Body Composition
Body Mass Index
Clinical Trials, Phase II as Topic
Colorectal Neoplasms
/ diagnostic imaging
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Muscle, Skeletal
/ pathology
Organ Size
Positron Emission Tomography Computed Tomography
Prognosis
Proportional Hazards Models
Tomography, X-Ray Computed
Adipose tissue
Chemotherapy
Colorectal cancer
Myosteatosis
Obesity
Prognosis
Sarcopenia
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
12 Feb 2019
12 Feb 2019
Historique:
received:
26
07
2018
accepted:
24
01
2019
entrez:
13
2
2019
pubmed:
13
2
2019
medline:
30
5
2019
Statut:
epublish
Résumé
The prognostic value of body composition in cancer patients has been widely studied during the last decade. The main finding of these studies is that sarcopenia, or skeletal muscle depletion, assessed by CT imaging correlates with a reduced overall survival (OS). By contrast, the prognostic value of fat mass remains ill-defined. This study aims to analyze the influence of body composition including both muscle mass and adipose tissue on OS in a homogeneous population of advanced colorectal cancer (CRC) patients. Among 235 patients with chemorefractory advanced CRC included in the SoMore and RegARd-C trials, body composition was assessed in 217 patients on baseline CT images. The relationship between body composition (sarcopenia, muscle density, subcutaneous and visceral fat index and density), body mass index (BMI) and OS were evaluated. Patients with a higher BMI had a better OS (≥30 versus < 30, HR: 0.50; 0.33-0.76). Those with low muscle index and muscle density had an increased mortality (HR: 2.06; 1.45-2.93 and HR: 1.54; 1.09-2.18, respectively). Likewise, low subcutaneous and visceral fat index were associated with an increased risk of dying (HR: 1.63; 1.23-2.17 and 1.48; 1.09-2.02 respectively), as were a high subcutaneous and visceral adipose tissue density (HR: 1.93; 1.44-2.57 and 2.40; 1.79-3.20 respectively). In multivariate analysis, a high visceral fat density was the main predictor of poor survival. Our results confirm the protective role of obesity in CRC patients at an advanced stage, as well as the negative prognostic impact of muscle depletion on survival. More importantly, our data show for the first time that visceral adipose tissue density is an important prognostic factor in metastatic CRC. NCT01290926 , 07/02/2011 and NCT01929616 , 28/08/2013.
Sections du résumé
BACKGROUND
BACKGROUND
The prognostic value of body composition in cancer patients has been widely studied during the last decade. The main finding of these studies is that sarcopenia, or skeletal muscle depletion, assessed by CT imaging correlates with a reduced overall survival (OS). By contrast, the prognostic value of fat mass remains ill-defined. This study aims to analyze the influence of body composition including both muscle mass and adipose tissue on OS in a homogeneous population of advanced colorectal cancer (CRC) patients.
METHODS
METHODS
Among 235 patients with chemorefractory advanced CRC included in the SoMore and RegARd-C trials, body composition was assessed in 217 patients on baseline CT images. The relationship between body composition (sarcopenia, muscle density, subcutaneous and visceral fat index and density), body mass index (BMI) and OS were evaluated.
RESULTS
RESULTS
Patients with a higher BMI had a better OS (≥30 versus < 30, HR: 0.50; 0.33-0.76). Those with low muscle index and muscle density had an increased mortality (HR: 2.06; 1.45-2.93 and HR: 1.54; 1.09-2.18, respectively). Likewise, low subcutaneous and visceral fat index were associated with an increased risk of dying (HR: 1.63; 1.23-2.17 and 1.48; 1.09-2.02 respectively), as were a high subcutaneous and visceral adipose tissue density (HR: 1.93; 1.44-2.57 and 2.40; 1.79-3.20 respectively). In multivariate analysis, a high visceral fat density was the main predictor of poor survival.
CONCLUSIONS
CONCLUSIONS
Our results confirm the protective role of obesity in CRC patients at an advanced stage, as well as the negative prognostic impact of muscle depletion on survival. More importantly, our data show for the first time that visceral adipose tissue density is an important prognostic factor in metastatic CRC.
TRIAL REGISTRATION
BACKGROUND
NCT01290926 , 07/02/2011 and NCT01929616 , 28/08/2013.
Identifiants
pubmed: 30744591
doi: 10.1186/s12885-019-5319-8
pii: 10.1186/s12885-019-5319-8
pmc: PMC6371452
doi:
Substances chimiques
Biomarkers
0
Banques de données
ClinicalTrials.gov
['NCT01290926', 'NCT01929616']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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