{"title":"Pretreatment bioelectrical impedance analysis predicts chemotherapy efficacy and toxicity in metastatic colorectal cancer patients.","authors":"Rikako Kato, Yuji Miyamoto, Hiyoshi Yukiharu, Maeda Yuto, Mayuko Ouchi, Katsuhiro Ogawa, Keisuke Kosumi, Kojiro Eto, Satoshi Ida, Masaaki Iwatsuki, Yoshifumi Baba, Hideo Baba","doi":"10.1016/j.clnesp.2025.02.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of body composition in metastatic colorectal cancer (mCRC) patients receiving systemic chemotherapy is increasingly recognized. This study aimed to explore the relationship between various body composition metrics measured using bioelectrical impedance analysis (BIA) and patient outcomes in patients with mCRC.</p><p><strong>Methods: </strong>In a retrospective cohort of 164 mCRC patients, body composition was assessed using BIA before first-line chemotherapy. Metrics evaluated included the extracellular water/total body water ratio (ECW/TBW), skeletal muscle mass, body fat mass, protein, and mineral levels. This study examined the relationship between these parameters and survival outcomes and their impact on chemotherapy-induced toxicity and relative dose intensity.</p><p><strong>Results: </strong>Patients with a higher ECW/TBW ratio had significantly lower overall survival (OS) (p<0.001) across quartiles (median OS: Q1=38.6 months, Q4=19.1 months) and a significantly lower progression-free survival (median progression-free survival: Q1=10.5 months, Q4=8.3 months; p=0.03). Multivariate analysis identified ECW/TBW as an independent predictor of OS (hazard ratio: 2.12; 95% confidence interval: 1.36-3.23; p<0.001). Subgroup analysis indicated a significant interaction between ECW/TBW quartiles and the effectiveness of anti-endothelial growth factor receptor and anti-vascular endothelial growth factor therapies on overall survival (p for interaction <0.001). Body composition was significantly associated with chemotherapy relative dose intensity and hematologic adverse events, particularly thrombocytopenia, which was significantly correlated with ECW/TBW, skeletal muscle mass, lean body mass, and protein levels.</p><p><strong>Conclusion: </strong>This study highlights the value of comprehensive body composition assessment using BIA in predicting outcomes for patients with mCRC, supporting its incorporation into clinical practice for enhanced patient care.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.clnesp.2025.02.015","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
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Abstract
Background: The prognostic significance of body composition in metastatic colorectal cancer (mCRC) patients receiving systemic chemotherapy is increasingly recognized. This study aimed to explore the relationship between various body composition metrics measured using bioelectrical impedance analysis (BIA) and patient outcomes in patients with mCRC.
Methods: In a retrospective cohort of 164 mCRC patients, body composition was assessed using BIA before first-line chemotherapy. Metrics evaluated included the extracellular water/total body water ratio (ECW/TBW), skeletal muscle mass, body fat mass, protein, and mineral levels. This study examined the relationship between these parameters and survival outcomes and their impact on chemotherapy-induced toxicity and relative dose intensity.
Results: Patients with a higher ECW/TBW ratio had significantly lower overall survival (OS) (p<0.001) across quartiles (median OS: Q1=38.6 months, Q4=19.1 months) and a significantly lower progression-free survival (median progression-free survival: Q1=10.5 months, Q4=8.3 months; p=0.03). Multivariate analysis identified ECW/TBW as an independent predictor of OS (hazard ratio: 2.12; 95% confidence interval: 1.36-3.23; p<0.001). Subgroup analysis indicated a significant interaction between ECW/TBW quartiles and the effectiveness of anti-endothelial growth factor receptor and anti-vascular endothelial growth factor therapies on overall survival (p for interaction <0.001). Body composition was significantly associated with chemotherapy relative dose intensity and hematologic adverse events, particularly thrombocytopenia, which was significantly correlated with ECW/TBW, skeletal muscle mass, lean body mass, and protein levels.
Conclusion: This study highlights the value of comprehensive body composition assessment using BIA in predicting outcomes for patients with mCRC, supporting its incorporation into clinical practice for enhanced patient care.
期刊介绍：
Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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