1587P - Sarcopenia affects treatment toxicity in metastatic colorectal cancer patients: results of a prospective multicenter study

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications of Treatment
Colon Cancer
Rectal Cancer
Presenter Maximilien Barret
Authors M. Barret1, C. Dalban2, J. Taieb3, D. Malka4, T. Mansourbakht5, E. Latko6, S. Antoun7
  • 1Gastroenterology, Hopital Européen Georges Pompidou, 75015 - Paris/FR
  • 2Department Of Biostatistics And Epidemiology (ea4184), Centre Georges François Leclerc, 21079 - Dijon/FR
  • 3Gastroenterology And Digestive Oncology, Hopital Européen Georges Pompidou, 75015 - Paris/FR
  • 4Oncology, Institut Gustave Roussy, Villejuif/FR
  • 5Gastroenterology, Hopital de la Pitié Salpetriere, Paris/FR
  • 6Nutricia Advanced Nutrition, Danone, St Ouen/FR
  • 7Emergency Department, Institut Gustave Roussy, Villejuif/FR

Abstract

Background

Malnutrition reduces tolerance to treatment, quality of life, and survival in numerous cancers, including metastatic colorectal cancer (mCRC). Previous studies have shown that chemotherapy toxicity may be linked to low muscle tissue (sarcopenia). Our study evaluated the effect of sarcopenia on chemotherapy toxicity among mCRC patients.

Methods

In this prospective, cross-sectional, multicenter study, demographic, oncological, and nutritional data were collected in all consecutive mCRC patients in three hospitals. Computed tomography (CT) images were analyzed using Slice-O-Matic software V4.3 (Tomovision) to evaluate cross-sectional areas (cm2) of muscle tissue (MT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). The 3rd lumbar vertebra (L3) was chosen as a reference, since L3 and whole-body measurements are linearly related. Indexed on height, MT, VAT and SAT (cm2/m2), were described, after stratification on sex. Sarcopenia was defined as MT <55 cm2/m2 for men (M) and <39 cm2/m2 for women (W). Images were obtained within one month of clinical evaluation. Toxicities were evaluated according to the NCI-CTC, version 3.0, in the two months following clinical evaluation.

Results

53 mCRC patients (72% M), participated in the study. According to body mass index (BMI) only 6.7% of F and 2.6% M were malnourished (BMI < 17 kg/m2), and 60% F and 42% M were of normal weight or overweight. These results are to be compared to the 38% F and 82% M of patients with sarcopenia. Grade 3-4 toxicities were observed in 28% of the cases, with neurotoxicity in 23%, diarrhea 15%, anemia 9.4%, leucopenia 9.4%, and nausea and vomiting 6%. In multivariate analysis including age, sex, BMI, sarcopenia, SAT and VAT, the only factor associated with grade 3-4 toxicity was sarcopenia (OR= 13.55 95% CI [1.08;169.31], p = 0.043).

Conclusions

In mCRC patients undergoing chemotherapy, sarcopenia was much more frequently observed (68%) than “visible” malnutrition (4%). Despite the small number of patients included in our study, we showed that sarcopenia was associated with severe chemotherapy toxicity.

Disclosure

M. Barret: The study received financial support from Nutricia Advanced Medical Nutrition®, St Ouen, France.

All other authors have declared no conflicts of interest.