Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease
Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was...
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| Veröffentlicht in: | Acta oncologica 2020-07, Vol.59 (7), p.799-808 |
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| creator | Shirdel, Mona Andersson, Fredrick Myte, Robin Axelsson, Jan Rutegård, Martin Blomqvist, Lennart Riklund, Katrine van Guelpen, Bethany Palmqvist, Richard Gylling, Björn |
| description | Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.
Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators.
Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival.
Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support. |
| doi_str_mv | 10.1080/0284186X.2020.1744716 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_infor</sourceid><recordid>TN_cdi_pubmed_primary_32228271</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>32228271</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-195fb36f53fe3d740385ad4bc6578c4dd80d62767080a96ce77ddac1892bb9503</originalsourceid><addsrcrecordid>eNp9kd1O3DAQha2qqGyBRyjyAzTUdhzbueO3PxJSbwrizprYzuKSrFd2wiri5XGUhUuuZjTznTnSHIS-UXJGiSI_CFOcKvFwxgjLI8m5pOITWlFR0YIx8fAZrWammKFD9DWl_4QQVsrqCzosGWOKSbpCL5fBTtiEfhuSH3zY4N5BGqOzuFnm45D7IfRhHWH7OGGfMKQUjId5sfPDY8a6EJ0ZoMMGNsZFnC88-2fovmPoUsB-gx3EbirSAGuHrU_ZxB2jgzav3cm-HqG7nzf_rn4Xt39__bm6uC0MV_VQ0Lpqm1K0Vdm60kpOSlWB5Y0RlVSGW6uIFUwKmd8CtTBOSmvBUFWzpqkrUh6hYrmbdm47NnobfQ9x0gG83o-ecuc0l4yT-kP-2t9f6BDXeuxHTUWtOM98tfAmhpSia98VlOg5LP0Wlp7D0vuwsu500WWT3tl31Vs6GThfAL9pQ-xhF2Jn9QBTfncb86d90uXHHq-nZafD</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease</title><source>MEDLINE</source><source>SWEPUB Freely available online</source><source>Free E-Journal (出版社公開部分のみ）</source><source>Taylor & Francis Journals Complete</source><source>Alma/SFX Local Collection</source><creator>Shirdel, Mona ; Andersson, Fredrick ; Myte, Robin ; Axelsson, Jan ; Rutegård, Martin ; Blomqvist, Lennart ; Riklund, Katrine ; van Guelpen, Bethany ; Palmqvist, Richard ; Gylling, Björn</creator><creatorcontrib>Shirdel, Mona ; Andersson, Fredrick ; Myte, Robin ; Axelsson, Jan ; Rutegård, Martin ; Blomqvist, Lennart ; Riklund, Katrine ; van Guelpen, Bethany ; Palmqvist, Richard ; Gylling, Björn</creatorcontrib><description>Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.
Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators.
Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival.
Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.</description><identifier>ISSN: 0284-186X</identifier><identifier>ISSN: 1651-226X</identifier><identifier>EISSN: 1651-226X</identifier><identifier>DOI: 10.1080/0284186X.2020.1744716</identifier><identifier>PMID: 32228271</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adenocarcinoma - complications ; Adenocarcinoma - pathology ; Adipose Tissue - diagnostic imaging ; Adult ; Aged ; Aged, 80 and over ; Body Composition ; Colon - pathology ; Colorectal Neoplasms - complications ; Colorectal Neoplasms - pathology ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Muscle, Skeletal - diagnostic imaging ; Neoplasm Staging ; Proportional Hazards Models ; Registries ; Retrospective Studies ; Sarcopenia - complications ; Sarcopenia - diagnostic imaging ; Survival Rate ; Tomography, X-Ray Computed</subject><ispartof>Acta oncologica, 2020-07, Vol.59 (7), p.799-808</ispartof><rights>2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-195fb36f53fe3d740385ad4bc6578c4dd80d62767080a96ce77ddac1892bb9503</citedby><cites>FETCH-LOGICAL-c489t-195fb36f53fe3d740385ad4bc6578c4dd80d62767080a96ce77ddac1892bb9503</cites><orcidid>0000-0002-2974-2003 ; 0000-0002-9692-101X ; 0000-0002-0974-6373 ; 0000-0002-4688-8952</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/0284186X.2020.1744716$$EPDF$$P50$$Ginformaworld$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/0284186X.2020.1744716$$EHTML$$P50$$Ginformaworld$$Hfree_for_read</linktohtml><link.rule.ids>230,314,551,777,781,882,27905,27906,59626,60415</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32228271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169844$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:143335927$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Shirdel, Mona</creatorcontrib><creatorcontrib>Andersson, Fredrick</creatorcontrib><creatorcontrib>Myte, Robin</creatorcontrib><creatorcontrib>Axelsson, Jan</creatorcontrib><creatorcontrib>Rutegård, Martin</creatorcontrib><creatorcontrib>Blomqvist, Lennart</creatorcontrib><creatorcontrib>Riklund, Katrine</creatorcontrib><creatorcontrib>van Guelpen, Bethany</creatorcontrib><creatorcontrib>Palmqvist, Richard</creatorcontrib><creatorcontrib>Gylling, Björn</creatorcontrib><title>Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease</title><title>Acta oncologica</title><addtitle>Acta Oncol</addtitle><description>Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.
Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators.
Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival.
Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.</description><subject>Adenocarcinoma - complications</subject><subject>Adenocarcinoma - pathology</subject><subject>Adipose Tissue - diagnostic imaging</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Composition</subject><subject>Colon - pathology</subject><subject>Colorectal Neoplasms - complications</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - diagnostic imaging</subject><subject>Neoplasm Staging</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - diagnostic imaging</subject><subject>Survival Rate</subject><subject>Tomography, X-Ray Computed</subject><issn>0284-186X</issn><issn>1651-226X</issn><issn>1651-226X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9kd1O3DAQha2qqGyBRyjyAzTUdhzbueO3PxJSbwrizprYzuKSrFd2wiri5XGUhUuuZjTznTnSHIS-UXJGiSI_CFOcKvFwxgjLI8m5pOITWlFR0YIx8fAZrWammKFD9DWl_4QQVsrqCzosGWOKSbpCL5fBTtiEfhuSH3zY4N5BGqOzuFnm45D7IfRhHWH7OGGfMKQUjId5sfPDY8a6EJ0ZoMMGNsZFnC88-2fovmPoUsB-gx3EbirSAGuHrU_ZxB2jgzav3cm-HqG7nzf_rn4Xt39__bm6uC0MV_VQ0Lpqm1K0Vdm60kpOSlWB5Y0RlVSGW6uIFUwKmd8CtTBOSmvBUFWzpqkrUh6hYrmbdm47NnobfQ9x0gG83o-ecuc0l4yT-kP-2t9f6BDXeuxHTUWtOM98tfAmhpSia98VlOg5LP0Wlp7D0vuwsu500WWT3tl31Vs6GThfAL9pQ-xhF2Jn9QBTfncb86d90uXHHq-nZafD</recordid><startdate>20200702</startdate><enddate>20200702</enddate><creator>Shirdel, Mona</creator><creator>Andersson, Fredrick</creator><creator>Myte, Robin</creator><creator>Axelsson, Jan</creator><creator>Rutegård, Martin</creator><creator>Blomqvist, Lennart</creator><creator>Riklund, Katrine</creator><creator>van Guelpen, Bethany</creator><creator>Palmqvist, Richard</creator><creator>Gylling, Björn</creator><general>Taylor & Francis</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ADHXS</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D93</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-2974-2003</orcidid><orcidid>https://orcid.org/0000-0002-9692-101X</orcidid><orcidid>https://orcid.org/0000-0002-0974-6373</orcidid><orcidid>https://orcid.org/0000-0002-4688-8952</orcidid></search><sort><creationdate>20200702</creationdate><title>Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease</title><author>Shirdel, Mona ; Andersson, Fredrick ; Myte, Robin ; Axelsson, Jan ; Rutegård, Martin ; Blomqvist, Lennart ; Riklund, Katrine ; van Guelpen, Bethany ; Palmqvist, Richard ; Gylling, Björn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-195fb36f53fe3d740385ad4bc6578c4dd80d62767080a96ce77ddac1892bb9503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma - complications</topic><topic>Adenocarcinoma - pathology</topic><topic>Adipose Tissue - diagnostic imaging</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Composition</topic><topic>Colon - pathology</topic><topic>Colorectal Neoplasms - complications</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - diagnostic imaging</topic><topic>Neoplasm Staging</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Sarcopenia - complications</topic><topic>Sarcopenia - diagnostic imaging</topic><topic>Survival Rate</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shirdel, Mona</creatorcontrib><creatorcontrib>Andersson, Fredrick</creatorcontrib><creatorcontrib>Myte, Robin</creatorcontrib><creatorcontrib>Axelsson, Jan</creatorcontrib><creatorcontrib>Rutegård, Martin</creatorcontrib><creatorcontrib>Blomqvist, Lennart</creatorcontrib><creatorcontrib>Riklund, Katrine</creatorcontrib><creatorcontrib>van Guelpen, Bethany</creatorcontrib><creatorcontrib>Palmqvist, Richard</creatorcontrib><creatorcontrib>Gylling, Björn</creatorcontrib><collection>Taylor & Francis Open Access(OpenAccess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>SWEPUB Umeå universitet full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Umeå universitet</collection><collection>SwePub Articles full text</collection><jtitle>Acta oncologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shirdel, Mona</au><au>Andersson, Fredrick</au><au>Myte, Robin</au><au>Axelsson, Jan</au><au>Rutegård, Martin</au><au>Blomqvist, Lennart</au><au>Riklund, Katrine</au><au>van Guelpen, Bethany</au><au>Palmqvist, Richard</au><au>Gylling, Björn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease</atitle><jtitle>Acta oncologica</jtitle><addtitle>Acta Oncol</addtitle><date>2020-07-02</date><risdate>2020</risdate><volume>59</volume><issue>7</issue><spage>799</spage><epage>808</epage><pages>799-808</pages><issn>0284-186X</issn><issn>1651-226X</issn><eissn>1651-226X</eissn><abstract>Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC.
Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n = 728) using Cox proportional hazards models and Kaplan-Meier estimators.
Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival.
Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>32228271</pmid><doi>10.1080/0284186X.2020.1744716</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2974-2003</orcidid><orcidid>https://orcid.org/0000-0002-9692-101X</orcidid><orcidid>https://orcid.org/0000-0002-0974-6373</orcidid><orcidid>https://orcid.org/0000-0002-4688-8952</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SWEPUB Freely available online; Free E-Journal (出版社公開部分のみ）; Taylor & Francis Journals Complete; Alma/SFX Local Collection |
| subjects | Adenocarcinoma - complications Adenocarcinoma - pathology Adipose Tissue - diagnostic imaging Adult Aged Aged, 80 and over Body Composition Colon - pathology Colorectal Neoplasms - complications Colorectal Neoplasms - pathology Female Humans Kaplan-Meier Estimate Male Middle Aged Muscle, Skeletal - diagnostic imaging Neoplasm Staging Proportional Hazards Models Registries Retrospective Studies Sarcopenia - complications Sarcopenia - diagnostic imaging Survival Rate Tomography, X-Ray Computed |
| title | Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease |
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