Albumin-myosteatosis gauge as a prognostic factor and its relationships with bioimpedancemetry in patients with colorectal-cancer.

Abstract

Objectives: The objective of this study was to evaluate the prognostic value of albumin-myosteatosis gauge (AMG) in Caucasian patients with non-metastatic colorectal cancer and to relate AMG with classic bioimpedancemetry (BIA) parameters.

Material and methods: This study involved 130 Caucasian patients diagnosed with non-metastasic colorectal cancer. CT scans were analysed at the L3 vertebral level to determine the cross-sectional area of skeletal muscle, skeletal muscle index (SMI), skeletal muscle density(SMD). Bioelectrical impedance analysis (BIA) was employed. Albumin and prealbumin were measured. The albumin-myosteatosis gauge (AMG) was calculated: serum albumin (g/dL) × skeletal muscle density (SMD) in Hounsfield Units (HU).

Results: The median age was 69.7 ± 9.7 years, with a range of 57-90 years. Patients with AMG values below the median had significantly reduced serum albumin levels, L3-SMI, SMD, SMI-BIA and phase angle. The patients who died during the follow-up of these 5 years had lower levels of serum albumin, body weight, BMI, SMD, phase angle, reactance, AMG and a higher percentage of low muscle mass according to CT and hospital readmissions. The AMG values were negatively correlated with age and positively with albumin, SMD, L3-SMI, phase angle and reactance. Significant differences in 5-year survival between the AMG groups (low median AMG vs High median AMG) (HR 3.83, IC95 % = 1.10-13.42 and the SMD groups (HR 3.57, IC95 % = 1.01-12.58) were observed. AMG was identified as an independent prognostic factor for survival (HR 4.83, 95%CI = 1.21-19.17) CONCLUSION: AMG may function as an independent prognostic marker in Caucasian patients with non-metastatic CRC.