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Effects of body composition profiles on oncological outcomes and postoperative intraabdominal infection following colorectal cancer surgery

Published:October 26, 2020DOI:https://doi.org/10.1016/j.soard.2020.10.022

      Highlights

      • Myopenia and adiposity show prognostic effects on DFS in patients with colorectal cancer
      • subcutaneous adipose tissue reflects an energetic storage favorable to face colorectal cancer
      • Muscle mass loss may represent a modifiable risk factor in colorectal cancer
      • Interpretation of CRP level must take into account adiposity to avoid unnecessary interventions

      Abstract

      Background

      Anthropometric data as prognostic factors of colorectal cancer are promising but contradictory. The aim of this study was to assess the preoperative body composition profiles as predictive factors for postoperative, oncologic, and inflammation outcomes.

      Objectives

      We sought to assess the impact of body composition profiles on short- and long-term outcomes and on postoperative inflammatory response in a clinical setting for patients following curative intent surgery for colorectal cancer.

      Setting

      University hopsital

      Methods

      We analyzed 122 patients from a prospective cohort (IMACORS) with colorectal cancer undergoing curative-intent surgery from 2011 to 2014. Musculature, total, visceral, and subcutaneous adiposity were measured from a preoperative CT scan and outcomes were compared between profiles.

      Results

      Preoperative myopenia was an independent predictive factor of recurrence (HR = 3.3 95% CI = 1.6–6.9; P = .002) while subcutaneous adiposity was a protective factor (HR = .4 95% CI = .2–.9; P = .03). No anthropometric measurement was predictive of overall survival and postoperative intra abdominal infection was not determined by body composition profiles. Preoperative and D4 CRP levels were significantly higher in patients with subcutaneous adiposity.

      Conclusions

      Myopenia and subcutaneous adiposity seemed to have independent and opposite prognostic effects on recurrence. Muscle mass loss may represent a modifiable risk factor while the amount of subcutaneous adipose tissue reflects an energetic storage favorable to face this pathologic process.

      Keywords

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