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Impact of body composition on prognosis and dose-limiting toxicities on metastatic colorectal cancer

2022-01-27Journal article Open access
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dc.contributor.authorDias, David da Silva
dc.contributor.authorMachado, Mafalda
dc.contributor.authorTrabulo, Carolina
dc.contributor.authorGosálbez, Beatriz
dc.contributor.authorRavasco, Paula
dc.date.accessioned2022-02-22T09:17:44Z
dc.date.available2022-02-22T09:17:44Z
dc.date.issued2022-01-27
dc.description.abstractSarcopenia is a progressive skeletal muscle disease, often present in oncological patients, that is associated with multiple adverse events such as worse prognosis, physical performance, and quality of life. Body composition evaluation by CT cross-section at the L3 vertebrae region appears to be a precise method to quantify skeletal muscle. The optimal cut-off for the definition of sarcopenia is not yet established, therefore the incidence of sarcopenia varies according to different studies. The main goal was to evaluate the presence of sarcopenia in patients with metastatic colorectal cancer (mCRC) and its impact on overall survival (OS) and dose-limiting toxicities (DLT). A retrospective cohort study of 178 patients with mCRC under first-line chemotherapy (ChT) in association with target therapy, in two hospital units, between January 2015 and December 2018. Skeletal mass area (SMA) was quantified with the NIH ImageJ software in CT cross-sectional images at the L3 vertebrae region. Statistical analysis was performed with IBM SPSS v25 software https://www.ibm.com/analytics/spss-statistics-software. The median age was 62 (SD ± 11) years old, 65% were men and 62.9% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0. The cut-off value was established based on ROC analysis, with sarcopenia defined as SMI < 49.12 cm2/m2 for men and < 35.85 cm2/m2 for women. Despite the mean body mass index (BMI) of 25.71 (± 4.71) kg/m2, half of the patients presented sarcopenia. In a multivariate analysis using a Cox regression model, an association was observed between OS and higher ECOG PS (p = 0.014; HR 5.46, CI 95% [1.42–21.10]), neutrophil-to-lymphocyte ratio (NLR) >2.80 (p = 0.038; HR 2.20, CI 95% [1,05–4.62]), and sarcopenia (p = 0.01; HR 4.73, CI 95% [1.85–12.09]). Additionally, in a logistic regression model, age (p = 0.014; OR 1.09, IC 95% [1.02–1.16]) and sarcopenia (p= 0.030, OR 4.13, IC 95% [1.15-14.8]) were associated with higher incidence of DLT. The CT evaluation of the body composition at the L3 region allows for the quantification of sarcopenia, providing prognostic information and predictive value of DLT in patients with mCRC, although the establishment of optimal cut-off values are required for implementation in clinical practice. A multimodal strategy to delay muscle waste should be considered in these patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3389/fnut.2021.671547pt_PT
dc.identifier.eid85124540440
dc.identifier.issn2296-861X
dc.identifier.pmcPMC8830532
dc.identifier.pmid35155507
dc.identifier.urihttp://hdl.handle.net/10400.14/36774
dc.identifier.wos000753829400001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectBody compositionpt_PT
dc.subjectBody mass indexpt_PT
dc.subjectDose limiting toxicitiespt_PT
dc.subjectMetastatic colorectal cancerpt_PT
dc.subjectNeutrophil-to-lymphocyte ratiopt_PT
dc.subjectSarcopeniapt_PT
dc.subjectSkeletal muscle indexpt_PT
dc.subjectSystemic inflammationpt_PT
dc.titleImpact of body composition on prognosis and dose-limiting toxicities on metastatic colorectal cancerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Nutritionpt_PT
oaire.citation.volume8pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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