Abstract
BackgroundWeight loss is recognised as a marker of poor prognosis in patients with cancer but the aetiology of cancer cachexia remains unclear. The aim of the present study was to examine the relationships between CT measured parameters of body composition and the systemic inflammatory response in patients with primary operable colorectal cancer.Patient and Methods174 patients with primary operable colorectal cancer who underwent resection with curative intent (2003–2010). Image analysis of CT scans was used to measure total fat index (cm2/m2), subcutaneous fat index (cm2/m2), visceral fat index (cm2/m2) and skeletal muscle index (cm2/m2). Systemic inflammatory response was measured by serum white cell count (WCC), neutrophil:lymphocyte ratio (NLR) and the Glasgow Prognostic Score (mGPS).ResultsThere were no relationships between any parameter of body composition and serum WCC or NLR. There was a significant relationship between low skeletal muscle index and an elevated systemic inflammatory response, as measured by the mGPS (p = 0.001). This was confirmed by linear relationships between skeletal muscle index and both C-reactive protein (r = −0.21, p = 0.005) and albumin (r = 0.31, p<0.001). There was no association between skeletal muscle index and tumour stage.ConclusionsThe present study highlights a direct relationship between low levels of skeletal muscle and the presence of a systemic inflammatory response in patients with primary operable colorectal cancer.
Highlights
1 in 3 people in the United Kingdom will develop cancer during their lifetime [1]
There were no relationships between any parameter of body composition and serum white cell count (WCC) or neutrophil:lymphocyte ratio (NLR)
There was a significant relationship between low skeletal muscle index and an elevated systemic inflammatory response, as measured by the modified Glasgow Prognostic Score (mGPS) (p = 0.001)
Summary
1 in 3 people in the United Kingdom will develop cancer during their lifetime [1]. Cachexia has long been recognised as a marker of poor prognosis in cancer patients; associated with an increased risk of surgical complications [4], resistance to chemotherapy [5,6], reduced quality of life [2] and decreased survival [7,8,9]. The clear link between weight loss, reduced performance status, impaired response to treatment and poor prognosis in such patients may be due to the preferential loss of skeletal muscle. Weight loss is recognised as a marker of poor prognosis in patients with cancer but the aetiology of cancer cachexia remains unclear. The aim of the present study was to examine the relationships between CT measured parameters of body composition and the systemic inflammatory response in patients with primary operable colorectal cancer. Systemic inflammatory response was measured by serum white cell count (WCC), neutrophil:lymphocyte ratio (NLR) and the Glasgow Prognostic Score (mGPS)
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