Download PDF
Rofo 2023; 195(03): 217-223
DOI: 10.1055/a-1936-2937
Interventional Radiology

Sarcopenia does not limit overall survival in patients with colorectal liver metastases undergoing interstitial brachytherapy

Sarkopenie beeinflusst nicht die Prognose von Patienten mit kolorektalen Lebermetastasen vor interstitieller Brachytherapie
Maximilian Thormann
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Franziska Heitmann
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Vanessa Wrobel
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Felix Barajas Ordonez
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Maciej Pech
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Alexey Surov
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Robert Damm
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
,
Jazan Omari
  University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Corrected by:

Erratum: Sarcopenia does not limit overall survival in patients with colorectal liver metastases undergoing interstitial brachytherapyRofo 2023; 195(03): e1-e1
DOI: 10.1055/a-2030-6723

Abstract

Purpose Several studies report an association of sarcopenia with survival in oncologic patients. The aim of this study is to assess the influence of sarcopenia on overall survival (OS) in patients with colorectal liver metastases undergoing interstitial brachytherapy (iBT)

Methods We identified 144 patients with colorectal liver metastases from our database from 2014–2017. Computed tomography (CT) chest scans at the L3 level were retrospectively analyzed. Psoas muscle area (PMA), psoas muscle index (PMI), and skeletal muscle gauge (SMG) were measured on the CT scan before treatment. Parameters were associated with overall survival.

Results 116 patients were included. Median overall survival was 27 months. Median PMA was 13.79 cm2, median PMI 4.51 cm2/m2. Neither PMA (HR 1.036, 95 % CI 0.996–1.078, p = 0.080), PMI (HR 1.068, 95 % CI 0.922–1.238, p = 0.382), nor SMG (HR 1.00, 95 % CI 0.998–1.003, p = 0.955) were significantly associated with overall survival.

Conclusion Sarcopenic patients undergoing iBT for colorectal liver metastases did not show decreased overall survival. If confirmed by comparative studies, sarcopenia may serve as a biomarker for treatment decision in patients with CRLM.

Key points: Sarcopenia is not a risk factor for survival in patients with CLRM undergoing iBT.

Citation Format

  • Thormann M, Heitmann F, Wrobel V et al. Sarcopenia does not limit overall survival in patients with colorectal liver metastases undergoing interstitial brachytherapy. Fortschr Röntgenstr 2023; 195: 217 – 223

Zusammenfassung

Ziel Mehrere Studien zeigen einen Einfluss von Sarkopenie auf das Überleben bei Krebspatienten. Ziel dieser Arbeit war die Untersuchung des Einflusses von Sarkopenie auf das Überleben bei Patienten mit kolorektalen Lebermetastasen vor interstitieller Brachytherapie (iBT).

Material und Methoden Retrospektiv wurden die Daten von 144 Patienten analysiert, die zwischen 2014 und 2017 eine interstitielle Brachytherapie bei kolorektalen Lebermetastasen in unserem Zentrum erhielten. Wir verwendeten die präinterventionelle Computertomografie (CT) auf Höhe L3 zur Bestimmung der psoas muscle area (PMA), des psoas muscle index (PMI) und des skeletal muscle gauge (SMG). Der Zusammenhang zwischen diesen Parametern und dem Überleben wurde untersucht.

Ergebnisse Insgesamt wurden 116 Patienten in die Analyse eingeschlossen. Das mediane Überleben betrug 27 Monate. Der mediane PMA war 13.79 cm2, der mediane PMI 4.51 cm2/m2. Weder PMA HR 1.036, 95 % CI 0.996–1.078, p = 0.080) noch PMI (HR 1.068, 95 % CI 0.922–1.238, p = 0.382) oder SMG (HR 1.00, 95 % CI 0.998–1.003, p = 0.955) korrelierten signifikant mit dem Überleben.

Schlussfolgerung Bei Patienten mit kolorektalen Lebermetastasen vor iBT zeigte Sarkopenie keinen Einfluss auf das Überleben. Wenn dies durch vergleichende Studien bestätigt wird, könnte die Sarkopenie als ein Biomarker für die Behandlungsentscheidung bei Patienten mit CRLM dienen.

Kernaussagen: Sarkopenie zeigt bei Patienten mit kolorektalen Lebermetastasen vor iBT keinen negativen Einfluss auf das Überleben.

Key words

colorectal cancer - interstitial brachytherapy - overall survival - sarcopenia


Publication History

Received: 24 March 2022

Accepted: 17 August 2022

Article published online:
25 October 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Gini A, Jansen EEL, Zielonke N. et al. Impact of colorectal cancer screening on cancer-specific mortality in Europe: A systematic review. Eur J Cancer 2020; 127: 224-235
    CrossrefPubMedGoogle Scholar
  • 2 Piawah S, Venook AP. Targeted therapy for colorectal cancer metastases: A review of current methods of molecularly targeted therapy and the use of tumor biomarkers in the treatment of metastatic colorectal cancer. Cancer 2019; 125: 4139-4147
    CrossrefPubMedGoogle Scholar
  • 3 Van Cutsem E, Cervantes A, Adam R. et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 2016; 27: 1386-1422
    CrossrefPubMedGoogle Scholar
  • 4 Tanis E, Nordlinger B, Mauer M. et al. Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983. Eur J Cancer 2014; 50: 912-919
    CrossrefPubMedGoogle Scholar
  • 5 Shady W, Petre EN, Gonen M. et al. Percutaneous Radiofrequency Ablation of Colorectal Cancer Liver Metastases: Factors Affecting Outcomes – A 10-year Experience at a Single Center. Radiology 2016; 278: 601
    CrossrefPubMedGoogle Scholar
  • 6 Jiang C, Davalos RV, Bischof JC. A review of basic to clinical studies of irreversible electroporation therapy. IEEE Trans Biomed Eng 2015; 62: 4-20
    CrossrefPubMedGoogle Scholar
  • 7 Van Hazel GA, Heinemann V, Sharma NK. et al. SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer. J Clin Oncol 2016; 34: 1723-1731
    CrossrefPubMedGoogle Scholar
  • 8 Collettini F, Lutter A, Schnapauff D. et al. Unresectable Colorectal Liver Metastases: Percutaneous Ablation Using CT-Guided High-Dose-Rate Brachytherapy (CT-HDBRT). RöFo – Fortschritte auf dem Gebiet der Röntgenstrahlen und der Bildgeb. Verfahren 2014; 186: 606-612
    PubMedGoogle Scholar
  • 9 Cruz-Jentoft AJ, Bahat G, Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48: 16-31
    CrossrefPubMedGoogle Scholar
  • 10 Gu DH, Kim MY, Seo YS. et al. Clinical usefulness of psoas muscle thickness for the diagnosis of sarcopenia in patients with liver cirrhosis. Clin Mol Hepatol 2018; 24: 319-330
    CrossrefPubMedGoogle Scholar
  • 11 Bak SH, Kwon SO, Han SS. et al. Computed tomography-derived area and density of pectoralis muscle associated disease severity and longitudinal changes in chronic obstructive pulmonary disease: a case control study. Respir Res 2019; 20: 226
    CrossrefPubMedGoogle Scholar
  • 12 Shachar SS, Deal AM, Weinberg M. et al. Body Composition as a Predictor of Toxicity in Patients Receiving Anthracycline and Taxane-Based Chemotherapy for Early-Stage Breast Cancer. Clin Cancer Res 2017; 23: 3537-3543
    CrossrefPubMedGoogle Scholar
  • 13 Sun G, Li Y, Peng Y. et al. Can sarcopenia be a predictor of prognosis for patients with non-metastatic colorectal cancer? A systematic review and meta-analysis. Int J Colorectal Dis 2018; 33: 1419-1427
    CrossrefPubMedGoogle Scholar
  • 14 Deng HY, Zha P, Peng L. et al. Preoperative sarcopenia is a predictor of poor prognosis of esophageal cancer after esophagectomy: a comprehensive systematic review and meta-analysis. Dis Esophagus 2019; 32 DOI: 10.1093/dote/doy115.
    CrossrefPubMedGoogle Scholar
  • 15 Mintziras I, Miligkos M, Wächter S. et al. Sarcopenia and sarcopenic obesity are significantly associated with poorer overall survival in patients with pancreatic cancer: Systematic review and meta-analysis. Int J Surg 2018; 59: 19-26
    CrossrefPubMedGoogle Scholar
  • 16 Ricke J, Mohnike K, Pech M. et al. Local Response and Impact on Survival After Local Ablation of Liver Metastases From Colorectal Carcinoma by Computed Tomography–Guided High-Dose-Rate Brachytherapy. Int J Radiat Oncol 2010; 78: 479-485
    CrossrefPubMedGoogle Scholar
  • 17 Seidensticker R, Damm R, Enge J. et al. Local ablation or radioembolization of colorectal cancer metastases: comorbidities or older age do not affect overall survival. BMC Cancer 2018; 18: 882
    CrossrefPubMedGoogle Scholar
  • 18 Bahat G, Turkmen BO, Aliyev S. et al. Cut-off values of skeletal muscle index and psoas muscle index at L3 vertebra level by computerized tomography to assess low muscle mass. Clin Nutr 2021; 40: 4360-4365
    CrossrefPubMedGoogle Scholar
  • 19 Pratesi A. Skeletal muscle: an endocrine organ. Clin CASES Miner BONE Metab 2013; 10: 11-14
    PubMedGoogle Scholar
  • 20 Pin F, Couch ME, Bonetto A. Preservation of muscle mass as a strategy to reduce the toxic effects of cancer chemotherapy on body composition. Curr Opin Support Palliat Care 2018; 12: 420-426
    CrossrefPubMedGoogle Scholar
  • 21 Deng H-Y, Hou L, Zha P. et al. Sarcopenia is an independent unfavorable prognostic factor of non-small cell lung cancer after surgical resection: A comprehensive systematic review and meta-analysis. Eur J Surg Oncol 2019; 45: 728-735
    CrossrefPubMedGoogle Scholar
  • 22 Vergara-Fernandez O, Trejo-Avila M, Salgado-Nesme N. Sarcopenia in patients with colorectal cancer: A comprehensive review. World J Clin Cases 2020; 8: 1188-1202
    CrossrefPubMedGoogle Scholar
  • 23 Murachi Y, Sakai D, Koseki J. et al. Impact of sarcopenia in patients with advanced or recurrent colorectal cancer treated with regorafenib. Int J Clin Oncol 2021; 26: 409-416
    CrossrefPubMedGoogle Scholar
  • 24 van Vledder MG, Levolger S, Ayez N. et al. Body composition and outcome in patients undergoing resection of colorectal liver metastases19. Br J Surg 2012; 99: 550-557
    CrossrefPubMedGoogle Scholar
  • 25 Trejo-Avila M, Bozada-Gutiérrez K, Valenzuela-Salazar C. et al. Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 2021; 36: 1077-1096
    CrossrefPubMedGoogle Scholar
  • 26 Peng PD, van Vledder MG, Tsai S. et al. Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. HPB 2011; 13: 439-446
    CrossrefPubMedGoogle Scholar
  • 27 Lodewick TM, Van Nijnatten TJA, Van Dam RM. et al. Are sarcopenia, obesity and sarcopenic obesity predictive of outcome in patients with colorectal liver metastases?. HPB (Oxford) 2015; 17: 438-446
    CrossrefPubMedGoogle Scholar
  • 28 Dodson RM, Firoozmand A, Hyder O. et al. Impact of Sarcopenia on Outcomes Following Intra-arterial Therapy of Hepatic Malignancies. J Gastrointest Surg 2013; 17: 2123-2132
    CrossrefPubMedGoogle Scholar
  • 29 Fujita M, Takahashi A, Hayashi M. et al. Skeletal muscle volume loss during transarterial chemoembolization predicts poor prognosis in patients with hepatocellular carcinoma. Hepatol Res 2019; 49: 778-786
    CrossrefPubMedGoogle Scholar
  • 30 Loosen SH, Schulze-Hagen M, Bruners P. et al. Sarcopenia Is a Negative Prognostic Factor in Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatic Malignancies. Cancers 2019; 11: 1503
    CrossrefPubMedGoogle Scholar
  • 31 Iritani S, Imai K, Takai K. et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol 2015; 50: 323-332
    CrossrefPubMedGoogle Scholar
  • 32 Fujiwara N, Nakagawa H, Kudo Y. et al. Sarcopenia, intramuscular fat deposition, and visceral adiposity independently predict the outcomes of hepatocellular carcinoma. J Hepatol 2015; 63: 131-140
    CrossrefPubMedGoogle Scholar
  • 33 Salman A, Salman M, Moustafa A. et al. Impact of Sarcopenia on Two-Year Mortality in Patients with HCV-Associated Hepatocellular Carcinoma After Radiofrequency Ablation. J Hepatocell Carcinoma 2021; 8: 313-320
    CrossrefPubMedGoogle Scholar