Assessment of body composition and association with clinical outcomes in patients with lung and colorectal cancer.

BJR open Pub Date : 2021-11-26 eCollection Date: 2021-01-01 DOI:10.1259/bjro.20210048
Naomi S Sakai, Anisha Bhagwanani, Timothy Jp Bray, Margaret A Hall-Craggs, Stuart Andrew Taylor
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Abstract

Objectives: To assess body composition in patients with non-small cell lung cancer (NSCLC) and colorectal cancer using whole-body MRI and relate this to clinical outcomes.

Methods: 53 patients with NSCLC (28 males, 25 females; mean age 66.9) and 74 patients with colorectal cancer (42 males, 32 females; mean age 62.9) underwent staging whole-body MRI scans, which were post-processed to derive fat mass (FM), fat free mass (FFM) and skeletal muscle (SM) indices and SM fat fraction (FF). These were compared between the two cancer cohorts using two-sided t-tests and the chi-squared test. Measurements of body composition were correlated with outcomes including length of hospital stay, metastatic status and mortality.

Results: Patients with NSCLC had significantly lower FFM (p = 0.0071) and SM (p = 0.0084) indices. Mean SM FF was greater in patients with NSCLC (p = 0.0124) and was associated with longer hospital stay (p = 0.035). There was no significant relationship between FM, FFM and SM indices and length of hospital stay, metastatic status or mortality.

Conclusions: Patients with NSCLC had lower FFM and SM indices than patients with colorectal cancer and greater SMFF, indicating lower SM mass with fatty infiltration. These findings reflect differences in the phenotype of the two groups and suggest patients with lung cancer are more likely to require additional nutritional support.

Advances in knowledge: Body composition differs between NSCLC and colorectal cancer. Patients with NSCLC have both a reduced SM mass and greater SM FF suggesting that they are more nutritionally deplete than patients with colorectal cancer.

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评估肺癌和结直肠癌患者的身体成分及其与临床结果的关系。
目的:利用全身磁共振成像技术评估非小细胞肺癌(NSCLC)和结直肠癌患者的身体成分,并将其与临床结果联系起来:方法:53 名非小细胞肺癌(NSCLC)患者(28 名男性,25 名女性;平均年龄 66.9)和 74 名结肠直肠癌患者(42 名男性,32 名女性;平均年龄 62.9)接受了全身 MRI 分期扫描,经过后处理得出脂肪量(FM)、无脂肪量(FFM)和骨骼肌(SM)指数以及骨骼肌脂肪分数(FF)。采用双侧 t 检验和卡方检验对两个癌症队列进行比较。身体成分测量结果与住院时间、转移状态和死亡率等结果相关:结果:NSCLC 患者的 FFM(p = 0.0071)和 SM(p = 0.0084)指数明显较低。NSCLC 患者的平均 SM FF 更大(p = 0.0124),并且与住院时间更长有关(p = 0.035)。FM、FFM和SM指数与住院时间、转移状态或死亡率之间没有明显关系:结论:与结直肠癌患者相比,NSCLC患者的FFM和SM指数较低,而SMFF指数较高,表明有脂肪浸润的SM质量较低。这些发现反映了两组患者表型的差异,并表明肺癌患者更有可能需要额外的营养支持:NSCLC和结肠直肠癌患者的身体组成不同。NSCLC患者的SM质量减少,SM FF增加,这表明他们比结直肠癌患者更缺乏营养。
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