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Skeletal Muscle Changes After Elective Colorectal Cancer Resection: A Longitudinal Study
George Malietzis1,2, Andrew C Currie1, Neil Johns3
1Department of Surgery, St Marks Hospital, Middlesex, UK.
Annals of Surgical Oncology
|March 24, 2016
Summary
Laparoscopy positively impacts skeletal muscle index after colorectal cancer surgery, while advanced disease stages negatively affect it. Monitoring body composition may offer therapeutic benefits for patients.
Area of Science:
- Oncology
- Surgical Research
- Body Composition Analysis
Background:
- Muscle depletion is a poor prognostic indicator in colorectal cancer (CRC) patients.
- Limited data exist on temporal body composition changes post-CRC surgery.
- This study investigates skeletal muscle index (SMI) trajectories after elective CRC surgery.
Purpose of the Study:
- To examine patient skeletal muscle index (SMI) trajectories over time after colorectal cancer (CRC) surgery.
- To identify factors influencing SMI alterations post-CRC surgery.
Main Methods:
- Analysis of serial computed tomography (CT) scans from 856 CRC patients undergoing elective resection (2006-2013).
- Calculation of lumbar skeletal muscle index (LSMI) using image analysis.
- Application of multilevel mixed-effect linear regression and growth curve models (GCM) to analyze LSMI changes over time.
Main Results:
- A quadratic GCM identified factors influencing LSMI trajectories.
- Laparoscopy was associated with a positive change in LSMI (p=0.03).
- Union for International Cancer Control (UICC) stage III+IV disease was linked to a negative LSMI curve change (p=0.03).
- Older age, female gender, higher ASA score, and elevated SIR were associated with lower LSMI over time.
Conclusions:
- Laparoscopy and a non-elevated systemic inflammatory response (SIR) favor skeletal muscle preservation/restoration post-CRC surgery.
- These findings suggest potential for therapeutic interventions targeting body composition monitoring and modification.
