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The clinical impact of preoperative body composition differs between male and female colorectal cancer patients
Author(s) -
Tokunaga R.,
Nakagawa S.,
Miyamoto Y.,
Ohuchi M.,
Izumi D.,
Kosumi K.,
Taki K.,
Higashi T.,
Miyata T.,
Yoshida N.,
Baba H.
Publication year - 2020
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14793
Subject(s) - medicine , hazard ratio , colorectal cancer , body mass index , cancer , sarcopenia , gastroenterology , oncology , confidence interval
Aim Patient body composition is an important indicator of metabolic status and is associated with cancer progression. Because body composition varies between men and women, we aimed to examine the difference in clinical impact of preoperative body composition according to sex. Method We used an integrated dataset of 559 colorectal cancer ( CRC ) patients. The association between preoperative body composition indices [body mass index ( BMI ), visceral to subcutaneous fat area ratio ( VSR ) and skeletal muscle index ( SMI )] and patient outcome, clinicopathological factors and preoperative inflammation and nutritional status was analysed, comparing men and women. Results Preoperative low BMI and low SMI in men was significantly associated with unfavourable overall survival ( OS ) [ BMI : hazard ratio ( HR ) 2.22, 95% CI 1.28–4.14, P = 0.004; SMI : HR 2.54, 95% CI 1.61–4.07, P < 0.001] and high VSR in women was significantly associated with unfavourable OS ( HR 1.79, 95% CI 1.03–3.02, P = 0.040). Additionally, low SMI in men was significantly associated with deeper tumour invasion and greater distant metastasis and high VSR in women was significantly associated with advanced age, right‐sided tumour, lower total lymphocyte count and lower albumin levels. Interestingly, low BMI in men was significantly associated with deeper tumour invasion, but also with favourable inflammation and nutritional status (lower C‐reactive protein and higher albumin). Conclusion The clinical impact of preoperative body composition differed between men and women: SMI in men and VSR in women were good prognosticators. Our findings may provide a novel insight for CRC treatment strategies.