Background: Sarcopenia, the age-related loss of muscle mass, is a negative prognostic factor in gastrointestinal cancer. Sarcopenia combined with visceral obesity (sarcopenic obesity) is associated with poor outcomes. We explored the influence of obesity and other factors on the prognosis of patients with colorectal cancer diagnosed with sarcopenia.Methods: We enrolled 211 patients with colorectal cancer diagnosed with preoperative sarcopenic obesity who underwent radical resection at Osaka University Hospital between January 2009 and January 2012. Muscle mass was assessed using the psoas muscle mass index. Obesity was evaluated by measuring the visceral fat area in the umbilical region. Patients were categorized into two groups: sarcopenia with obesity (SO) and sarcopenia without obesity (non-SO). Overall survival, cancer-specific survival, and cancer-related relapse-free survival (CRRFS) were compared between the two groups. Patient characteristics, including age, sex, body mass index, serum albumin, C-reactive protein, tumor markers, prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and geriatric nutritional risk index (GNRI), were also analyzed.Results: CRRFS was significantly shorter in the SO group than in the non-SO group (p= 0.028). PNI, mGPS, and GNRI were not identified as significant prognostic factors for CRRFS. Multivariate analysis highlighted sarcopenic obesity, elevated carcinoembryonic antigen levels, and unfavorable histological types as significant predictors of poor CRRFS outcomes.Conclusions: Sarcopenic obesity is an independent predictor of poor prognosis in patients with CRC. Thus, interventions aimed at increasing muscle mass and reducing visceral fat could potentially improve the prognosis of these patients.
背景：肌肉减少症，即与年龄相关的肌肉质量下降，是胃肠道癌症的不良预后因素。肌肉减少症合并内脏肥胖（即肌肉减少性肥胖）与不良预后相关。本研究探讨了肥胖及其他因素对诊断为肌肉减少症的结直肠癌患者预后的影响。 方法：我们纳入了2009年1月至2012年1月期间在大阪大学医院接受根治性切除术的211例术前诊断为肌肉减少性肥胖的结直肠癌患者。肌肉质量通过腰大肌质量指数进行评估。肥胖通过测量脐部水平的内脏脂肪面积来评估。患者被分为两组：肌肉减少伴肥胖组（SO组）和肌肉减少不伴肥胖组（非SO组）。比较两组患者的总生存期、癌症特异性生存期和癌症相关无复发生存期（CRRFS）。同时分析了患者特征，包括年龄、性别、体重指数、血清白蛋白、C反应蛋白、肿瘤标志物、预后营养指数（PNI）、改良格拉斯哥预后评分（mGPS）和老年营养风险指数（GNRI）。 结果：SO组的CRRFS显著短于非SO组（p=0.028）。PNI、mGPS和GNRI未被确定为CRRFS的显著预后因素。多变量分析显示，肌肉减少性肥胖、癌胚抗原水平升高以及不良组织学类型是CRRFS预后不良的显著预测因子。 结论：肌肉减少性肥胖是结直肠癌患者预后不良的独立预测因子。因此，旨在增加肌肉质量和减少内脏脂肪的干预措施可能改善这些患者的预后。
肿瘤(癌症)患者之家