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Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy

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Abstract

Purpose

The purpose of this study was to elucidate the effect of decreased muscle mass on the toxicity and survival of patients with colon cancer treated with adjuvant chemotherapy after surgery.

Methods

We reviewed the data of 229 consecutive patients with stage III colon cancer who received adjuvant oxaliplatin, 5-fluorouracil, and leucovorin chemotherapy at a single center between 2003 and 2010. Baseline muscle mass was assessed by measuring the cross-sectional area of the psoas muscle at the level of the fourth lumbar vertebra on computed tomography images. Effects of muscle mass on toxicity of chemotherapy and survival were assessed.

Results

The median age of the 229 patients was 61 years (range, 28–80) and 134 (58.5 %) were men. The mean psoas muscle mass index (PI, psoas muscle area divided by height2 [mm2/m2]) was 548.3. A 1 SD decrement in the PI was associated with an increase in all grade 3–4 toxicities in univariate (OR = 1.69, 95 % CI = 1.18–2.27) and multivariate (OR = 1.56, 95 % CI = 1.05–2.38) analyses. In univariate analysis, the PI was not associated with overall survival. However, multivariate analysis showed that a 1 SD decrement in the PI increased the hazard of overall mortality by 85 % (HR = 1.85, 95 % CI = 1.10–3.13). This effect of the PI on mortality was maintained in subgroup analyses, especially in older and obese patients.

Conclusions

Decreased muscle mass was associated with increased risk of grade 3–4 toxicity and poor prognosis in patients with stage III colon cancer.

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Acknowledgments

Sources of funding

This study was supported in part by grant number 02-2014-046 from the SNUBH Research Fund and by study number 1320370 from the National R&D Program for Cancer Control, Ministry for Health and Welfare, Republic of Korea.

Conflicts of interest

None

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Authors and Affiliations

  1. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 463-707, South Korea

    Hee-Won Jung, Jin Won Kim, Ji-Yeon Kim, Sun-Wook Kim, Keun-Wook Lee, Kwang-il Kim, Cheol-Ho Kim & Jee Hyun Kim

  2. Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 463-707, South Korea

    Hyun Kyung Yang & Joon Woo Lee

  3. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 463-707, South Korea

    Duck-Woo Kim & Sung-Bum Kang

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  1. Hee-Won Jung
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  2. Jin Won Kim
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  3. Ji-Yeon Kim
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  11. Cheol-Ho Kim
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Corresponding author

Correspondence to Jee Hyun Kim.

Additional information

Hee-Won Jung and Jin Won Kim contributed equally to this work.

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Jung, HW., Kim, J.W., Kim, JY. et al. Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy. Support Care Cancer 23, 687–694 (2015). https://doi.org/10.1007/s00520-014-2418-6

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  • DOI: https://doi.org/10.1007/s00520-014-2418-6

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