title: The relationships between body composition and the systemic inflammatory response in patients with primary operable colorectal cancer.
abstract: BACKGROUND
  Weight loss is recognised as a marker of poor prognosis in patients with cancer but the aetiology of cancer cachexia remains unclear. The aim of the present study was to examine the relationships between CT measured parameters of body composition and the systemic inflammatory response in patients with primary operable colorectal cancer.
  
  
  METHODS
  174 patients with primary operable colorectal cancer who underwent resection with curative intent (2003-2010). Image analysis of CT scans was used to measure total fat index (cm(2)/m(2)), subcutaneous fat index (cm(2)/m(2)), visceral fat index (cm(2)/m(2)) and skeletal muscle index (cm(2)/m(2)). Systemic inflammatory response was measured by serum white cell count (WCC), neutrophil:lymphocyte ratio (NLR) and the Glasgow Prognostic Score (mGPS).
  
  
  RESULTS
  There were no relationships between any parameter of body composition and serum WCC or NLR. There was a significant relationship between low skeletal muscle index and an elevated systemic inflammatory response, as measured by the mGPS (p = 0.001). This was confirmed by linear relationships between skeletal muscle index and both C-reactive protein (r = -0.21, p = 0.005) and albumin (r = 0.31, p<0.001). There was no association between skeletal muscle index and tumour stage.
  
  
  CONCLUSIONS
  The present study highlights a direct relationship between low levels of skeletal muscle and the presence of a systemic inflammatory response in patients with primary operable colorectal cancer.
authors.affiliation: University Department of Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom. colinrichards@nhs.net
authors.forename: Colin H
authors.initials: CH
authors.lastname: Richards
authors.forename: Campbell S D
authors.initials: CS
authors.lastname: Roxburgh
authors.forename: Mark T
authors.initials: MT
authors.lastname: MacMillan
authors.forename: Sanad
authors.initials: S
authors.lastname: Isswiasi
authors.forename: Ewen G
authors.initials: EG
authors.lastname: Robertson
authors.forename: Graeme K
authors.initials: GK
authors.lastname: Guthrie
authors.forename: Paul G
authors.initials: PG
authors.lastname: Horgan
authors.forename: Donald C
authors.initials: DC
authors.lastname: McMillan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050218:Body Fat Distribution; D015179:Colorectal Neoplasms / Q000097:blood / Q000503:physiopathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed