Age as a Modifier of the Effects of Sarcopenia on Survival Among Colon Cancer Patients Receiving Chemotherapy.

Abstract

Background: Sarcopenia is common among older adults and is associated with poor prognosis in several malignancies. This study evaluated whether sarcopenia serves as a survival risk factor among patients with colon cancer treated with chemotherapy, alongside the effects of age and visceral adiposity (VA).

Patients and methods: We retrospectively recruited 133 patients diagnosed with resectable colon cancer who received chemotherapy between January 2014 and December 2017 at a teaching hospital. Computed tomography images were analyzed to assess body composition, and Kaplan-Meier survival curves and Cox proportional hazards regression models were used to assess survival.

Results: Patients receiving chemotherapy who were diagnosed with sarcopenia were associated with worse 5-year overall survival (OS: 87.3% vs. 65.4%) and longer hospital stay (19.1 vs. 15 days) compared with patients without sarcopenia. VA was not associated with OS or the length of hospital stay. There was a significant association between sarcopenia and OS, with a hazard ratio (HR) of 2.77 (95% confidence interval [CI]:1.42-5.38). The association remained after adjustment for other independent risk factors, including age > 70 years (adjusted HR: 1.98, 95% CI: 0.99-3.95) and alcohol consumption (adjusted HR: 8.96, 95% CI: 1.22-65.77). In age-stratified analyses, sarcopenia was an independent risk factor for worse OS (adjusted HR: 7.85, 95% CI: 1.05-58.91) among patients > 70 years but not among patients ≤ 70 years (adjusted HR: 2.01, 95% CI: 0.75-5.93).

Conclusion: Sarcopenia is associated with improved OS, particularly in patients aged ≥ 70 years who underwent chemotherapy after resection of colorectal cancer.