Negative Impact of Skeletal Muscle Loss after Systemic Chemotherapy in Patients with Unresectable Colorectal Cancer

• Published in: PloS one Vol. 10; no. 6; p. e0129742
• Main Authors: Miyamoto, Yuji, Baba, Yoshifumi, Sakamoto, Yasuo, Ohuchi, Mayuko, Tokunaga, Ryuma, Kurashige, Junji, Hiyoshi, Yukiharu, Iwagami, Shiro, Yoshida, Naoya, Watanabe, Masayuki, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12.06.2015; Public Library of Science (PLoS)
• Subjects: Aged; Body composition; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Clinical outcomes; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - complications; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - drug therapy; Computed tomography; Confidence intervals; Cross sections; Female; Health aspects; Hospitals; Humans; Hypothesis testing; Liver cancer; Lung cancer; Male; Medical imaging; Medical prognosis; Melanoma; Metastasis; Mortality; Muscles; Musculoskeletal system; Patients; Prognosis; Regression analysis; Sarcopenia; Sarcopenia - complications; Sarcopenia - epidemiology; Skeletal muscle; Statistical analysis; Surgery; Surgical outcomes; Survival; Survival analysis; Tumors; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0129742

Skeletal muscle depletion (sarcopenia) is closely associated with limited physical ability and high mortality. This study evaluated the prognostic significance of skeletal muscle status before and after chemotherapy in patients with unresectable colorectal cancer (CRC). We conducted a retrospective analysis of 215 consecutive patients with unresectable CRC who underwent systemic chemotherapy. Skeletal muscle cross-sectional area was measured by computed tomography. We evaluated the prognostic value of skeletal muscle mass before chemotherapy and the rate of skeletal muscle change in cross-sectional area after chemotherapy. One-hundred-eighty-two patients met our inclusion criteria. There were no significant differences in progression-free survival (PFS) or overall survival (OS) associated with skeletal muscle mass before chemotherapy. However, 22 patients with skeletal muscle loss (>5%) after chemotherapy showed significantly shorter PFS and OS compared with those without skeletal muscle loss (PFS, log-rank p = 0.029; OS, log-rank p = 0.009). Multivariate Cox regression analysis revealed that skeletal muscle loss after chemotherapy (hazard ratio, 2.079; 95% confidence interval, 1.194-3.619; p = 0.010) was independently associated with OS. Skeletal muscle loss after chemotherapy was an independent, negative prognostic factor in unresectable CRC.