Prognostic Impact of a Nutritional Index Including Muscle Volume in Stage 4 Colorectal Cancer.
BACKGROUND
Nutritional status influences cancer prognosis. Measurement of the area of the psoas muscle on computed tomography is useful for evaluation of skeletal muscle mass and prediction of prognosis.


METHODS
The psoas muscle index (PMI) was determined in 42 patients undergoing surgery for stage 4 colorectal cancer. Patients were classified into high and low PMI groups using a cutoff of 5.5×10-4cm2m-2Relationships of PMI with prognosis, chemotherapy period, and postoperative complications were examined.


RESULTS
The 3-year overall survival rate was 24.0%. PMI was significantly associated with 3-year OS in univariate (high vs. low PMI: 43.0% vs. 12.9%, p=0.0415) and multivariate (p=0.0146) analyses. A low PMI was associated with a shorter period of chemotherapy. A reduction in PMI was a predictor of a poor prognosis.


CONCLUSIONS
PMI status is related to the period of chemotherapy and is an independent prognostic factor in patients with stage 4 colorectal cancer.
Department of Surgery, Nara City Hospital, Nara, Japan drgechum@koto.kpu-m.ac.jp.
Tomoyuki
T
Nagata
Department of Surgery, Nara City Hospital, Nara, Japan.
Yuen
Y
Nakase
Department of Surgery, Nara City Hospital, Nara, Japan.
Kei
K
Nakamura
Department of Surgery, Nara City Hospital, Nara, Japan.
Akira
A
Sougawa
Department of Surgery, Nara City Hospital, Nara, Japan.
Satoshi
S
Mochiduki
Department of Surgery, Nara City Hospital, Nara, Japan.
Shozo
S
Kitai
Department of Surgery, Nara City Hospital, Nara, Japan.
Seishiro
S
Inaba
D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D015596:Nutrition Assessment; D009752:Nutritional Status; D009929:Organ Size; D017063:Outcome Assessment, Health Care / Q000379:methods; D011379:Prognosis; D016658:Psoas Muscles / Q000473:pathology*
Psoas muscle; nutritional index; stage 4 colorectal cancer