Cargando…

Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer

The impact of longitudinal anthropometric changes during adjuvant chemotherapy on long-term survival in non-metastatic colon cancer is unclear. Herein, we analyzed the prognostic significance of computed tomography (CT)-measured body composition changes in colon cancer patients who underwent surgery...

Descripción completa

Detalles Bibliográficos
Autores principales: Chung, Eric, Lee, Hye Sun, Cho, Eun-Suk, Park, Eun Jung, Baik, Seung Hyuk, Lee, Kang Young, Kang, Jeonghyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016804/
https://www.ncbi.nlm.nih.gov/pubmed/31878325
http://dx.doi.org/10.3390/cancers12010060
_version_ 1783497059581558784
author Chung, Eric
Lee, Hye Sun
Cho, Eun-Suk
Park, Eun Jung
Baik, Seung Hyuk
Lee, Kang Young
Kang, Jeonghyun
author_facet Chung, Eric
Lee, Hye Sun
Cho, Eun-Suk
Park, Eun Jung
Baik, Seung Hyuk
Lee, Kang Young
Kang, Jeonghyun
author_sort Chung, Eric
collection PubMed
description The impact of longitudinal anthropometric changes during adjuvant chemotherapy on long-term survival in non-metastatic colon cancer is unclear. Herein, we analyzed the prognostic significance of computed tomography (CT)-measured body composition changes in colon cancer patients who underwent surgery followed by adjuvant FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin) chemotherapy. Data of 167 patients with stage III or high-risk stage II colon cancer were analyzed. Skeletal muscle index (SMI), skeletal muscle radiodensity (SMR), visceral fat index (VFI), subcutaneous fat index (SFI), and total fat index (TFI) changes during chemotherapy were calculated using preoperative and postchemotherapy CT image data. The Cox proportional hazard model was used to determine the correlation between changes in anthropometric values and overall survival (OS). The median changes (%) in SMI, SMR, VFI, SFI, and TFI over 210 days during chemotherapy were 8.7% (p < 0.001), 3.4% (p = 0.001), −19% (p < 0.001), −3.4% (p = 0.936), and −11.9% (p < 0.001), respectively. Cut-off values of changes in SMI (skeletal muscle index change, SMIC) and SMR (skeletal muscle radiodensity change, SMRC) were defined at −2% and −2 Hounsfield units (HU) respectively, whereas those of changes in VFI (visceral fat index change, VFIC), SFI (subcutaneous fat index change, SFIC), and TFI (total fat index change, TFIC) were based on values that provided the largest χ2 on the Mantel–Cox test. Multivariable analysis revealed that low SMR measured on a postchemotherapy CT scan (hazard ratio, HR: 0.32, 95% confidence interval, CI: 0.15–0.70, p = 0.004) and visceral fat loss of at least 46.57% (HR: 0.31, 95% CI: 0.14–0.69, p = 0.004) were independent poor prognostic factors for OS. Severe visceral fat loss during FOLFOX chemotherapy and low skeletal muscle radiodensity measured on postchemotherapy CT scans are associated with poor OS in stage III and high-risk stage II colon cancer patients.
format Online
Article
Text
id pubmed-7016804
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-70168042020-02-28 Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer Chung, Eric Lee, Hye Sun Cho, Eun-Suk Park, Eun Jung Baik, Seung Hyuk Lee, Kang Young Kang, Jeonghyun Cancers (Basel) Article The impact of longitudinal anthropometric changes during adjuvant chemotherapy on long-term survival in non-metastatic colon cancer is unclear. Herein, we analyzed the prognostic significance of computed tomography (CT)-measured body composition changes in colon cancer patients who underwent surgery followed by adjuvant FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin) chemotherapy. Data of 167 patients with stage III or high-risk stage II colon cancer were analyzed. Skeletal muscle index (SMI), skeletal muscle radiodensity (SMR), visceral fat index (VFI), subcutaneous fat index (SFI), and total fat index (TFI) changes during chemotherapy were calculated using preoperative and postchemotherapy CT image data. The Cox proportional hazard model was used to determine the correlation between changes in anthropometric values and overall survival (OS). The median changes (%) in SMI, SMR, VFI, SFI, and TFI over 210 days during chemotherapy were 8.7% (p < 0.001), 3.4% (p = 0.001), −19% (p < 0.001), −3.4% (p = 0.936), and −11.9% (p < 0.001), respectively. Cut-off values of changes in SMI (skeletal muscle index change, SMIC) and SMR (skeletal muscle radiodensity change, SMRC) were defined at −2% and −2 Hounsfield units (HU) respectively, whereas those of changes in VFI (visceral fat index change, VFIC), SFI (subcutaneous fat index change, SFIC), and TFI (total fat index change, TFIC) were based on values that provided the largest χ2 on the Mantel–Cox test. Multivariable analysis revealed that low SMR measured on a postchemotherapy CT scan (hazard ratio, HR: 0.32, 95% confidence interval, CI: 0.15–0.70, p = 0.004) and visceral fat loss of at least 46.57% (HR: 0.31, 95% CI: 0.14–0.69, p = 0.004) were independent poor prognostic factors for OS. Severe visceral fat loss during FOLFOX chemotherapy and low skeletal muscle radiodensity measured on postchemotherapy CT scans are associated with poor OS in stage III and high-risk stage II colon cancer patients. MDPI 2019-12-24 /pmc/articles/PMC7016804/ /pubmed/31878325 http://dx.doi.org/10.3390/cancers12010060 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chung, Eric
Lee, Hye Sun
Cho, Eun-Suk
Park, Eun Jung
Baik, Seung Hyuk
Lee, Kang Young
Kang, Jeonghyun
Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title_full Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title_fullStr Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title_full_unstemmed Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title_short Changes in Body Composition during Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer
title_sort changes in body composition during adjuvant folfox chemotherapy and overall survival in non-metastatic colon cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016804/
https://www.ncbi.nlm.nih.gov/pubmed/31878325
http://dx.doi.org/10.3390/cancers12010060
work_keys_str_mv AT chungeric changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT leehyesun changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT choeunsuk changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT parkeunjung changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT baikseunghyuk changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT leekangyoung changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer
AT kangjeonghyun changesinbodycompositionduringadjuvantfolfoxchemotherapyandoverallsurvivalinnonmetastaticcoloncancer