Surgical oncology · 2026
Association of preoperative body composition with disease recurrence and mortality in colorectal cancer patients: A competing risk analysis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Petersen Anne E, van Helsdingen Claire P M, Boudeling Kevin, Twisk Jos W R, Konsten Joop L M, Bouvy Nicole D, Stoot Jan H M B, Tanis Pieter J, de Jonge Wouter J, Hemke Robert, Derikx Joep P M
Аннотация
BACKGROUND: Previous studies have shown that low skeletal muscle mass and excess adiposity are predictors of mortality both in the general population and in colorectal cancer (CRC) patients. However, it remains unclear whether body composition is associated with disease recurrence. The aim of this study was to investigate the association between body composition and recurrence in patients with non-metastatic CRC, while explicitly accounting for the competing risk of non-CRC-related mortality.
METHODS: This prospective multicenter study included stage I-III CRC patients undergoing curative-intent resection. Body composition was assessed on axial CT images at the third lumbar (L3) and supra-acetabular (SA) levels. Visceral, subcutaneous, and intermuscular adipose tissue and skeletal muscle mass and density were quantified. Recurrence, CRC-related mortality, and non-CRC-related mortality were analyzed using Fine and Gray competing risks models.
RESULTS: Among 402 patients with a median age of 68 years, 70 (17%) developed recurrence and 67 (17%) died during a median follow-up of 5.0 years (IQR 4.4-5.3; range 0.1-10.0). Of the 67 deaths, 34 (51%) were due to non-CRC-related causes. None of the 11 body composition parameters were associated with recurrence. Higher skeletal muscle mass at the SA level was associated with lower all-cause mortality (HR 0.71, 95% CI 0.59-0.84, p = 0.003) and CRC-related mortality (HR 0.67, 95% CI 0.50-0.90, p = 0.01). Higher visceral fat mass was associated with higher non-CRC-related mortality (HR 1.07, 95% CI 1.01-1.14, p = 0.02).
CONCLUSIONS: Preoperative body composition was not associated with recurrence in non-metastatic CRC and is therefore unlikely to represent a modifiable target for reducing recurrence risk. Nonetheless, skeletal muscle mass was associated with both CRC-related and non-CRC-related mortality, suggesting that its optimization may reduce these risks through mechanisms independent of recurrence.
METHODS: This prospective multicenter study included stage I-III CRC patients undergoing curative-intent resection. Body composition was assessed on axial CT images at the third lumbar (L3) and supra-acetabular (SA) levels. Visceral, subcutaneous, and intermuscular adipose tissue and skeletal muscle mass and density were quantified. Recurrence, CRC-related mortality, and non-CRC-related mortality were analyzed using Fine and Gray competing risks models.
RESULTS: Among 402 patients with a median age of 68 years, 70 (17%) developed recurrence and 67 (17%) died during a median follow-up of 5.0 years (IQR 4.4-5.3; range 0.1-10.0). Of the 67 deaths, 34 (51%) were due to non-CRC-related causes. None of the 11 body composition parameters were associated with recurrence. Higher skeletal muscle mass at the SA level was associated with lower all-cause mortality (HR 0.71, 95% CI 0.59-0.84, p = 0.003) and CRC-related mortality (HR 0.67, 95% CI 0.50-0.90, p = 0.01). Higher visceral fat mass was associated with higher non-CRC-related mortality (HR 1.07, 95% CI 1.01-1.14, p = 0.02).
CONCLUSIONS: Preoperative body composition was not associated with recurrence in non-metastatic CRC and is therefore unlikely to represent a modifiable target for reducing recurrence risk. Nonetheless, skeletal muscle mass was associated with both CRC-related and non-CRC-related mortality, suggesting that its optimization may reduce these risks through mechanisms independent of recurrence.