Linear Skeletal Muscle Index and Muscle Attenuation May Be New Prognostic Factors in Colorectal Carcinoma Treated by Radical Resection.
Linear Skeletal Muscle Index and Muscle Attenuation May Be New Prognostic Factors in Colorectal Carcinoma Treated by Radical Resection.
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DOI：
10.3389/fonc.2022.839899
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发表时间：
2022
影响因子：
4.7
通讯作者：
Liu M
中科院分区：
文献类型：
--
作者：
Wang Y;Wang Y;Ai L;Zhang H;Li G;Wang Z;Jiang X;Yan G;Liu Y;Wang C;Xiong H;Wang G;Liu M
本研究旨在评估结直肠癌根治术患者的身体成分与临床参数和预后之间的关系。回顾性收集患者年龄、体重指数（BMI）、肠梗阻和肿瘤相关因素的基线数据。使用计算机断层扫描（CT）测量身体组成参数，如内脏脂肪面积（VFA）、总腹肌面积（TAMA）、肌肉衰减（MA）、后肾脂肪厚度（PPNF）和肌间脂肪面积（IMF）。我们还提出了一种新的线性骨骼肌指数（LSMI）预测因子，可以在临床上轻松地在CT上测量。随访终点为无病生存和全因死亡。我们在医院或通过电话对患者进行随访。进行单因素和多因素考克斯比例风险分析，以确定与预后相关的危险因素。使用Kaplan-Meier方法进行生存分析，并建立列线图以预测生存。共有1761例CRC患者（中位年龄62岁）入选本研究，其中201例患有肠梗阻，673例BMI > 24.0。全组患者3、5年无瘤生存率分别为84.55%和68.60%，总生存率分别为88.87%和76.38%。经考克斯回归分析，总生存期与MA、LSMI、SMI、肿瘤大小、N分期、有无转移、是否有辅助治疗等因素相关（p < 0.05）。肿瘤进展风险与MA、VFA、LSMI、SMI、男性、N分期、转移和辅助治疗显著相关（p < 0.05）。此外，在中国人群中，我们发现MA < 30.0 HU，LSMI < 18.2，SMI < 38.0的女性患者预后较差，MA < 37.6 HU，LSMI < 21.9，SMI < 40.3的男性患者预后较差。我们的研究结果表明，线性骨骼肌指数和MA可以作为新的独立预测结直肠癌患者接受根治性手术治疗，基线数据，如身体成分参数，LSMI和肿瘤相关因素可以共同预测患者的预后。这些结果可以帮助我们优化手术后患者的管理和治疗。
This study evaluated the association between body composition and clinical parameters and prognosis in patients with colorectal cancer (CRC) treated by radical resection. Baseline data on patient age, body mass index (BMI), bowel obstruction and tumor-related factors were collected retrospectively. Body composition parameters such as visceral fat area (VFA), total abdominal muscle area (TAMA), muscle attenuation (MA), posterior renal fat thickness (PPNF) and intermuscular fat area (IMF) are measured using Computed tomography (CT) scans. We also propose a new predictor of linear skeletal muscle index (LSMI) that can be easily measured clinically at CT. Follow-up endpoints were disease-free survival and all-cause death. We follow up with patients in hospital or by telephone. Univariate and multifactorial Cox proportional hazards analyses were performed to identify risk factors associated with prognosis. Survival analysis was performed using the Kaplan-Meier method and a nomogram was established to predict survival. A total of 1761 patients (median age 62 years) with CRC were enrolled in our study, of whom 201 had intestinal obstruction and 673 had a BMI > 24.0. Among all patients, the 3- and 5-year disease-free survival rates were 84.55% and 68.60% respectively, and the overall survival rates were 88.87% and 76.38%. Overall survival was significantly correlated with MA, LSMI, SMI, Tumor size, N stage, metastasis and adjuvant therapy by Cox regression analysis (p < 0.05). The risk of tumor progression was significantly associated with MA, VFA, LSMI, SMI, Male, N stage, metastasis and adjuvant therapy (p < 0.05). In addition, based on the Chinese population, we found that female patients with MA < 30.0 HU, LSMI < 18.2, and SMI < 38.0 had a worse prognosis, male patients with MA < 37.6 HU, LSMI < 21.9, and SMI < 40.3 had a poorer prognosis. Our findings suggest that linear skeletal muscle index and MA can be used as new independent predictors for colorectal cancer patients treated with radical surgery, and that baseline data such as body composition parameters, LSMI and tumor-related factors can collectively predict patient prognosis. These results could help us to optimize the management and treatment of patients after surgery.
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DOI：
10.1002/jcsm.12267
发表时间：
2018-04
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Daly LE;Ní Bhuachalla ÉB;Power DG;Cushen SJ;James K;Ryan AM
通讯作者：
Ryan AM
影响因子：
23.4
作者：
Davidiuk, Andrew J.;Parker, Alexander S.;Thiel, David D.
通讯作者：
Thiel, David D.
影响因子：
7
作者：
Heymsfield, Steven B.;Gonzalez, M. Cristina;Zheng, Jolene
通讯作者：
Zheng, Jolene
影响因子：
8.9
作者：
Brown, Justin C.;Caan, Bette J.;Prado, Carla M.
通讯作者：
Prado, Carla M.
影响因子：
3.9
作者：
Barbalho, Erica Roberta;Gonzalez, Maria Cristina;Trussardi Fayh, Ana Paula
通讯作者：
Trussardi Fayh, Ana Paula