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Low skeletal muscle radiodensity is a risk factor for adjuvant chemotherapy discontinuation in colorectal cancer

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Abstract

Background

Previously, we reported SMR (skeletal muscle radiodensity) as a potential prognostic marker for colorectal cancer. However, there have been limited studies on the association between SMR and the continuation of adjuvant chemotherapy in colorectal cancer.

Methods

In this retrospective study, 143 colorectal cancer patients underwent curative surgery and adjuvant chemotherapy using the CAPOX regimen. Patients' SMRs were measured from preoperative CT images and divided into low (bottom quarter) and high (top three quarters) SMR groups. We compared chemotherapy cycles, capecitabine and oxaliplatin doses, and adverse effects in each group.

Results

The low SMR group had significantly fewer patients completing adjuvant chemotherapy compared to the high SMR group (44% vs. 68%, P < 0.01). Capecitabine and oxaliplatin doses were also lower in the low SMR group. Incidences of Grade 2 or Grade 3 adverse effects did not differ between groups, but treatment discontinuation due to adverse effects was significantly higher in the low SMR group. Logistic regression analysis revealed Stage III disease (odds ratio 18.09, 95% CI 1.41–231.55) and low SMR (odds ratio 3.26, 95% CI 1.11–9.56) as factors associated with unsuccessful treatment completion. Additionally, a higher proportion of low SMR patients received fewer than 2 cycles of chemotherapy (50% vs. 12%).

Conclusion

The low SMR group showed higher treatment incompletion rates and received lower drug doses during adjuvant chemotherapy. Low SMR independently contributed to treatment non-completion in colorectal cancer patients.

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Funding

This study was conducted through the use of internal funds.

Author information

Authors and Affiliations

  1. Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, 252-0374, 1-15-1, Kitasato, Minami-Ku, Sagamihara, Kanagawa, Japan

    Keigo Yokoi, Akiko Watanabe, Kazuko Yokota, Keita Kojima, Toshimichi Tanaka, Ken Kojo, Hirohisa Miura, Takahiro Yamanashi & Takeshi Naitoh

  2. Department of Clinical Skills Education, Research and Development Center for Medical Education, Kitasato University School of Medicine, 252-0374, 1-15-1, Kitasato, Minami-Ku, Sagamihara, Kanagawa, Japan

    Takeo Sato

  3. Division of Advanced Surgical Oncology, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 252-0374, 1-15-1, Kitasato, Minami-Ku, Sagamihara, Kanagawa, Japan

    Keishi Yamashita

  4. Department of General-Pediatric-Hepatobiliary Pancreatic Surgery, Kitasato University School of Medicine, 252-0374, 1-15-1, Kitasato, Minami-Ku, Sagamihara, Kanagawa, Japan

    Yusuke Kumamoto

  5. Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, 252-0374, 1-15-1, Kitasato, Minami-Ku, Sagamihara, Kanagawa, Japan

    Naoki Hiki

Authors
  1. Keigo Yokoi
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  2. Akiko Watanabe
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  3. Kazuko Yokota
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  4. Keita Kojima
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  5. Toshimichi Tanaka
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  6. Ken Kojo
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  7. Hirohisa Miura
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  8. Takahiro Yamanashi
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  9. Takeo Sato
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  10. Keishi Yamashita
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  11. Yusuke Kumamoto
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  12. Naoki Hiki
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  13. Takeshi Naitoh
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Corresponding author

Correspondence to Takeshi Naitoh.

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Conflict of interest

Dr. Yokoi, Dr. Watanabe, Dr. Yokota, Dr. Kojima, Dr. Tanaka, Dr. Kojo, Dr. Miura, Dr. Yamanashi, and Dr. Yamashita have no conflicts of interest to disclose. Dr. Naioth receives research grant from Medtronic, Chugai Pharmaceutical, and Taiho Pharmaceutical. Dr. Naitoh also receives honoraria from Johnson & Johnson, Medtronic, and Olympus. Dr. Hiki receives research grant from Abbot Japan, EA Pharma, Eli Lilly Japan, Johnson & Johnson, Otsuka Pharmaceutical, Otsuka Pharmaceutical Factory, Kaken Pharmaceutical, Covidien Japan, Shionogi, Takeda Pharmaceutical Company, Daiichi Sankyo, Taiho pharmaceutical, Chugai Pharmaceutical, Tsumura, Terumo Corporation, Hogy Medical, Miyarisan Pharmaceutical, and Yakult. Dr. Hiki also receives honoraria from AstraZeneca, Abbot Japan, EA Pharma, Johnson & Johnson, Otsuka Pharmaceutical, Olympus Medical Science Sales Corporation, Kaken Pharmaceutical, Covidien Japan, Zeria Pharmaceutical, Takeda Pharmaceutical, Daiichi Sankyo Company, Taiho Pharmaceutical, Tsumura, Terumo Corporation, Novartis Pharma, Biofermin Pharmaceutical, Fuji Pharma, Mitsubishi Research Institute, Miyarisan Pharmaceutical, and Yakult. Dr. Sato receives research grant from Taiho Pharmaceutical and Johnson & Johnson. Dr. Sato also receives consulting fee from Takeda Pharmaceutical and Kaken Pharmaceutical. Dr. Sato also receives honoraria from Takeda Pharmaceutical, Eli Lilly, Taiho Pharmaceutical, Daiichi Sankyo Company, Chugai Pharmaceutical, Bayer, and Yakult. Dr. Kumamoto receives grant from Taiho Pharmaceutical, Chugai Pharmaceutical, Johnson & Johnson, Eli Lilly Japan, Kaken Pharmaceutical, Terumo Corporation, Daiichi Sankyo Company, and Yakult. Dr. Kumamoto receives honoraria from Taiho Pharmaceutical, Viatris Pharmaceutical, Takeda Pharmaceutical, Kaken Pharmaceutical, and Johnson & Johnson.

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Yokoi, K., Watanabe, A., Yokota, K. et al. Low skeletal muscle radiodensity is a risk factor for adjuvant chemotherapy discontinuation in colorectal cancer. Int J Clin Oncol 29, 276–285 (2024). https://doi.org/10.1007/s10147-023-02463-2

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  • DOI: https://doi.org/10.1007/s10147-023-02463-2

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