Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients
Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients
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DOI：
10.1007/s00432-018-2736-z
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发表时间：
2018-11-01
影响因子：
3.6
通讯作者：
Winkels, R. M.
中科院分区：
文献类型：
--
作者：
van Baar, Harm;Beijer, S.;Winkels, R. M.
背景在预后不良的癌症患者中，低骨骼肌放射密度与较高的死亡率相关。这种关联是否也适用于早期癌症尚不清楚。我们的目的是研究骨骼肌密度与早期（I-III期）结直肠癌（CRC）患者总体死亡率之间的关系。此外，我们研究了骨骼肌密度和CRC特异性死亡率和无病生存率之间的关联，在一个研究population. MethodsSkeleton肌肉密度进行了评估，在2006年和2015年之间诊断的1681例早期CRC患者，使用术前计算机断层扫描图像。调整后的考克斯比例风险模型被用来评估肌肉密度和总死亡率，CRC特异性死亡率和无病生存率之间的关联ResultsThe中位数随访时间为48个月（范围0- 119个月）。在39%的CRC患者中检测到低肌肉密度。低肌肉密度与较高的死亡率显著相关（低与正常：校正HR 1.91，95% CI 1.53-2.38）。合并症分层后，有2种合并症的患者的相关性最高（HR 2.11，95% CI 1.55-2.87）。此外，骨骼肌密度低与无病生存率差显著相关（HR 1.68，95% CI 1.14-2.47），但不存在CRC特异性死亡率（HR 1.68，95%CI 0.89-3.17）in a subset of the study population.ConclusionIn early stage CRC patients，low muscle density is significantly associated with higher overall mortality，和更差的无病生存率。
BackgroundIn cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I-III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population.MethodsSkeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival.ResultsThe median follow-up time was 48 months (range 0-119months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53-2.38). After stratification for comorbidities, the association was highest in patients with 2 comorbidities (HR 2.11, 95% CI 1.55-2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14-2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89-3.17) in a subset of the study population.ConclusionIn early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.