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

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-10-03 DOI:10.1007/s12029-025-01320-x

Hideki Tanda, Masatsune Shibutani, Yuki Seki, Tsuyoshi Nishiyama, Hiroaki Kasashima, Tatsunari Fukuoka, Kiyoshi Maeda

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引用次数: 0

Abstract

Purpose: Tumor progression is influenced by both tumor-intrinsic and host-related factors. Among the latter, cachexia-a multifactorial syndrome involving progressive skeletal muscle loss-has garnered increasing attention for its prognostic relevance. However, objective assessment of cachexia remains difficult. The cachexia index (CXI) has emerged as a novel biomarker for its evaluation. This study aimed to assess the relationship between cachexia and long-term prognosis following curative surgery for colorectal cancer (CRC) using a modified index.

Methods: We retrospectively analyzed 298 patients who underwent curative colorectal cancer resection at Osaka City University Hospital between January 2017 and December 2019. A modified version of CXI, termed the P-CXI, was calculated using the psoas muscle index (cm²/m²), serum albumin (g/dL), and neutrophil-to-lymphocyte ratio (NLR): P-CXI = (psoas muscle index × albumin) / NLR. Patients were stratified into high and low P-CXI groups. Prognostic value for relapse-free survival (RFS) and overall survival (OS) was evaluated using univariate and multivariate Cox regression analyses.

Results: The low P-CXI group (n = 170) had significantly shorter RFS and OS compared to that of the high P-CXI group (p = 0.001 and p < 0.001, respectively). Multivariate analysis identified low P-CXI as an independent poor prognostic factor for RFS (HR: 2.627, 95% CI 1.363-5.063, p = 0.004) and OS (HR: 5.370, 95% CI 1.806-15.96, p = 0.002), along with older age, T4 tumors, and elevated CA 19-9.

Conclusion: Cachexia, as quantified by P-CXI, was significantly associated with worse long-term outcomes after curative CRC resection. P-CXI may serve as a simple and objective prognostic marker.

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恶病质对大肠癌根治术患者预后影响的回顾性研究。

目的：肿瘤的进展受肿瘤固有因素和宿主相关因素的影响。在后者中，恶病质——一种涉及进行性骨骼肌损失的多因素综合征——因其与预后的相关性而受到越来越多的关注。然而，客观评估恶病质仍然很困难。恶病质指数（cachexia index， CXI）已成为一种新的生物标志物。本研究旨在评估恶病质与结直肠癌（CRC）治愈性手术后长期预后的关系。方法：回顾性分析2017年1月至2019年12月在大阪市立大学医院接受治愈性结直肠癌切除术的298例患者。CXI的改进版本称为P-CXI，使用腰肌指数（cm2/m2），血清白蛋白（g/dL）和中性粒细胞与淋巴细胞比值（NLR）计算：P-CXI =（腰肌指数×白蛋白）/ NLR。将患者分为高、低P-CXI组。采用单因素和多因素Cox回归分析评估无复发生存期（RFS）和总生存期（OS）的预后价值。结果：与高p - cxi组相比，低p - cxi组（n = 170）的RFS和OS显著缩短（p = 0.001和p）。结论：以p - cxi量化的恶病质与根治性结直肠癌切除术后较差的长期预后显著相关。P-CXI可作为一种简单、客观的预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.