Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients

Harm van Baar, S. Beijer, M. J.L. Bours, M. P. Weijenberg, M. van Zutphen, F. J.B. van Duijnhoven, G. D. Slooter, J. F.M. Pruijt, J. J. Dronkers, A. Haringhuizen, E. J. Spillenaar Bilgen, B. M.E. Hansson, J. H.W. de Wilt, E. Kampman, R. M. Winkels

Research output: Contribution to journalArticle

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Abstract

Background: In cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I–III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. Methods: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. Results: The median follow-up time was 48 months (range 0–119 months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53–2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95% CI 1.55–2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14–2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89–3.17) in a subset of the study population. Conclusion: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.

Original languageEnglish (US)
Pages (from-to)2139-2147
Number of pages9
JournalJournal of Cancer Research and Clinical Oncology
Volume144
Issue number11
DOIs
StatePublished - Nov 1 2018

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Disease-Free Survival
Colorectal Neoplasms
Muscles
Mortality
Skeletal Muscle
Comorbidity
Proportional Hazards Models
Population
Neoplasms
Tomography

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

van Baar, H., Beijer, S., Bours, M. J. L., Weijenberg, M. P., van Zutphen, M., van Duijnhoven, F. J. B., ... Winkels, R. M. (2018). Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients. Journal of Cancer Research and Clinical Oncology, 144(11), 2139-2147. https://doi.org/10.1007/s00432-018-2736-z
van Baar, Harm ; Beijer, S. ; Bours, M. J.L. ; Weijenberg, M. P. ; van Zutphen, M. ; van Duijnhoven, F. J.B. ; Slooter, G. D. ; Pruijt, J. F.M. ; Dronkers, J. J. ; Haringhuizen, A. ; Spillenaar Bilgen, E. J. ; Hansson, B. M.E. ; de Wilt, J. H.W. ; Kampman, E. ; Winkels, R. M. / Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients. In: Journal of Cancer Research and Clinical Oncology. 2018 ; Vol. 144, No. 11. pp. 2139-2147.
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title = "Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients",
abstract = "Background: In cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I–III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. Methods: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. Results: The median follow-up time was 48 months (range 0–119 months). Low muscle density was detected in 39{\%} of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95{\%} CI 1.53–2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95{\%} CI 1.55–2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95{\%} CI 1.14–2.47), but not with CRC-specific mortality (HR 1.68, 95{\%} CI 0.89–3.17) in a subset of the study population. Conclusion: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.",
author = "{van Baar}, Harm and S. Beijer and Bours, {M. J.L.} and Weijenberg, {M. P.} and {van Zutphen}, M. and {van Duijnhoven}, {F. J.B.} and Slooter, {G. D.} and Pruijt, {J. F.M.} and Dronkers, {J. J.} and A. Haringhuizen and {Spillenaar Bilgen}, {E. J.} and Hansson, {B. M.E.} and {de Wilt}, {J. H.W.} and E. Kampman and Winkels, {R. M.}",
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van Baar, H, Beijer, S, Bours, MJL, Weijenberg, MP, van Zutphen, M, van Duijnhoven, FJB, Slooter, GD, Pruijt, JFM, Dronkers, JJ, Haringhuizen, A, Spillenaar Bilgen, EJ, Hansson, BME, de Wilt, JHW, Kampman, E & Winkels, RM 2018, 'Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients', Journal of Cancer Research and Clinical Oncology, vol. 144, no. 11, pp. 2139-2147. https://doi.org/10.1007/s00432-018-2736-z

Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients. / van Baar, Harm; Beijer, S.; Bours, M. J.L.; Weijenberg, M. P.; van Zutphen, M.; van Duijnhoven, F. J.B.; Slooter, G. D.; Pruijt, J. F.M.; Dronkers, J. J.; Haringhuizen, A.; Spillenaar Bilgen, E. J.; Hansson, B. M.E.; de Wilt, J. H.W.; Kampman, E.; Winkels, R. M.

In: Journal of Cancer Research and Clinical Oncology, Vol. 144, No. 11, 01.11.2018, p. 2139-2147.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients

AU - van Baar, Harm

AU - Beijer, S.

AU - Bours, M. J.L.

AU - Weijenberg, M. P.

AU - van Zutphen, M.

AU - van Duijnhoven, F. J.B.

AU - Slooter, G. D.

AU - Pruijt, J. F.M.

AU - Dronkers, J. J.

AU - Haringhuizen, A.

AU - Spillenaar Bilgen, E. J.

AU - Hansson, B. M.E.

AU - de Wilt, J. H.W.

AU - Kampman, E.

AU - Winkels, R. M.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: In cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I–III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. Methods: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. Results: The median follow-up time was 48 months (range 0–119 months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53–2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95% CI 1.55–2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14–2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89–3.17) in a subset of the study population. Conclusion: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.

AB - Background: In cancer patients with a poor prognosis, low skeletal muscle radiographic density is associated with higher mortality. Whether this association also holds for early-stage cancer is not very clear. We aimed to study the association between skeletal muscle density and overall mortality among early-stage (stage I–III) colorectal cancer (CRC) patients. Furthermore, we investigated the association between skeletal muscle density and both CRC-specific mortality and disease-free survival in a subset of the study population. Methods: Skeletal muscle density was assessed in 1681 early-stage CRC patients, diagnosed between 2006 and 2015, using pre-operative computed tomography images. Adjusted Cox proportional hazard models were used to evaluate the association between muscle density and overall mortality, CRC-specific mortality and disease-free survival. Results: The median follow-up time was 48 months (range 0–119 months). Low muscle density was detected in 39% of CRC patients. Low muscle density was significantly associated with higher mortality (low vs. normal: adjusted HR 1.91, 95% CI 1.53–2.38). After stratification for comorbidities, the association was highest in patients with ≥ 2 comorbidities (HR 2.11, 95% CI 1.55–2.87). Furthermore, low skeletal muscle density was significantly associated with poorer disease-free survival (HR 1.68, 95% CI 1.14–2.47), but not with CRC-specific mortality (HR 1.68, 95% CI 0.89–3.17) in a subset of the study population. Conclusion: In early-stage CRC patients, low muscle density was significantly associated with higher overall mortality, and worse disease-free survival.

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U2 - 10.1007/s00432-018-2736-z

DO - 10.1007/s00432-018-2736-z

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VL - 144

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JO - Journal of Cancer Research and Clinical Oncology

JF - Journal of Cancer Research and Clinical Oncology

SN - 0171-5216

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