Prognostic Impact of Cachexia in Patients Undergoing Radical Resection for Colorectal Cancer: A Retrospective Study

Area of Science:

• Oncology
• Clinical Medicine
• Biomarkers

Background:

• Cachexia, a syndrome of progressive muscle loss, is a significant factor influencing tumor progression and patient prognosis.
• Objective assessment of cachexia is challenging, necessitating novel biomarkers.
• The cachexia index (CXI) has emerged as a potential tool for evaluating cachexia.

Purpose of the Study:

• To evaluate the relationship between cachexia, quantified by a modified cachexia index (P-CXI), and long-term prognosis in colorectal cancer (CRC) patients undergoing curative surgery.
• To determine if P-CXI can serve as an objective prognostic marker in CRC.

Main Methods:

• Retrospective analysis of 298 patients who underwent curative colorectal cancer resection.
• Calculation of a modified cachexia index (P-CXI) using psoas muscle index, serum albumin, and neutrophil-to-lymphocyte ratio (NLR).
• Stratification into high and low P-CXI groups and evaluation of prognostic value for relapse-free survival (RFS) and overall survival (OS) using Cox regression analysis.

Main Results:

• Patients in the low P-CXI group exhibited significantly shorter RFS and OS compared to the high P-CXI group.
• Multivariate analysis identified low P-CXI as an independent predictor of poor RFS and OS.
• Other independent poor prognostic factors included older age, T4 tumors, and elevated CA 19-9.

Conclusions:

• Cachexia, as measured by the P-CXI, is significantly associated with worse long-term outcomes in patients with colorectal cancer following curative resection.
• The P-CXI demonstrates potential as a simple and objective prognostic marker for colorectal cancer patients.