Host phenotype is associated with reduced survival independent of tumour biology in patients with colorectal liver metastases

David P. J. van Dijk, Matthew Krill, Farshad Farshidfar, Ting Li, Sander S. Rensen, Steven W. M. Olde Damink, Elijah Dixon, Francis R. Sutherland, Chad G. Ball, Vera C. Mazurak, Vickie E. Baracos, Oliver F. Bathe*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Web of Science)

Abstract

Background Most prognostic scoring systems for colorectal liver metastases (CRLMs) account for factors related to tumour biology. Little is known about the effects of the host phenotype to the tumour. Our objective was to delineate the relationship of systemic inflammation and body composition features [i.e. low skeletal muscle mass (sarcopenia) and low visceral adipose tissue (VAT)], two well-described host phenotypes in cancer. Methods Clinical data and pre-operative blood samples were collected from 99 patients who underwent resection of CRLM. Pre-operative computed tomography scans were available for 97 patients; body composition was analysed at the L3 level, stratified for sex and age. Clinicopathological variables, serum C-reactive protein (CRP), and various body composition variables were evaluated. Overall survival was evaluated as a function of these same variables in multivariate Cox regression analysis. Results Skeletal muscle was significantly correlated with VAT (r = 0.46, P <0.001). Of patients with sarcopenia, 35 (65%) also had low VAT. C-reactive protein was elevated (>= 5 mg/mL) in 42 patients (43.3%). Elevated CRP was more common in patients with sarcopenia (73.8% vs. 51.1%, P = 0.029). The most significant prognostic factors were the coincidence of elevated CRP and adverse body composition features (sarcopenia and/or low VAT; hazard ratio 4.3, 95% confidence interval 1.5-13.0, P = 0.008), as well as Fong clinical prognostic score (hazard ratio 2.9, 95% confidence interval 1.5-5.5, P = 0.002). Conclusions Body composition in patients with CRLM is not directly linked to the presence of systemic inflammation. However, when systemic inflammation coincides with sarcopenia and/or low VAT, prognosis is adversely affected, independent of the Fong clinical prognostic score.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalJournal of cachexia, sarcopenia and muscle
Volume10
Issue number1
DOIs
Publication statusPublished - Feb 2019

Keywords

  • Colorectal cancer
  • Liver metastases
  • Inflammation
  • Sarcopenia
  • C-REACTIVE PROTEIN
  • BODY-COMPOSITION
  • HEPATIC RESECTION
  • SKELETAL-MUSCLE
  • VISCERAL ADIPOSITY
  • PROGNOSTIC-FACTOR
  • CANCER CACHEXIA
  • SARCOPENIA
  • OUTCOMES
  • OBESITY

Cite this