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Age-adjusted Charlson comorbidity index and its association with body composition and overall survival in patients with colorectal cancer

Affiliations
  • 1Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil.
  • 2Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil.
  • 3Luiz Antonio Hospital, Liga Norteriograndense Contra O Câncer, Natal, Rio Grande Do Norte, Brazil.
  • 4Department of Nutrition, Cancer Hospital II, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil.
  • 5Postgraduate Program in Nutrition and Health, Ceara State University, Fortaleza Ceara, Brazil.
  • 6Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
  • 7Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
  • 8Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
  • 9Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada.
  • 10Health Sciences Center, Postgraduate Program in Nutrition, Federal University of Rio Grande Do Norte, Natal, Rio Grande Do Norte, Brazil. ana.fayh@ufrn.br.
  • 11Health Sciences Center, Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, no 3000, Natal, Rio Grande Do Norte, 59078-970, Brazil. ana.fayh@ufrn.br.
  • 12PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande Do Norte, Natal, Brazil. ana.fayh@ufrn.br.

Published on:

July 16, 2024

Abstract

OBJECTIVE

To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC).

RESEARCH METHODS AND PROCEDURES

In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established.

RESULTS

A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3-6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17-5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard ( HR 5.12, 95% CI 2.73-9.57; HR 4.58, 95% CI 2.37-8.85; and HR 2.36, 95% CI 1.07-5.22, respectively).

CONCLUSION

The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.

Keywords:

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