Prognostic significance of unintentional body weight loss in colon cancer patients

Abstract

The aim of the present study was to investigate whether unintentional body weight loss (BWL) provides additional clinical information in terms of tumor progression and prognosis in non-metastatic colon cancer. In the present study, a total of 2,406 consecutive colon cancer patients without metastasis were retrospectively enrolled. Unintentional BWL was defined as loss of >5% of body weight within the last 6–12 months, or defined subjectively upon fulfillment of at least two of the following: Evidence of change in clothing size and corroboration of the reported weight loss by family or friend. This category was recorded as present (‘with’) or absent (‘without’). Logistic regression analysis was performed to determine the correlation between BWL and the tumor characteristics and post-operative outcomes of patients with colon cancer. The Cox regression model was used to determine the association of BWL with long-term survival of colon cancer patients. A significant association between BWL and tumor location [right vs. left: Odds ratio (OR)=1.62; P<0.001], tumor size (≥5 vs. <5 cm: OR=2.17; P<0.001), and tumor stage based on the tumor-nodes-metastasis system (T3-T4 vs. T1-T2: OR=2.02; P<0.001). Post-operative morbidity and mortality were not significantly influenced by BWL. Multivariate analysis revealed that BWL was significantly associated with overall survival [with vs. without BWL: Hazard ratio (HR)=1.178; P=0.036] and relapse-free survival (with vs. without BWL: HR=1.332; P=0.003). In conclusion, BWL in patients with colon cancer is not just a symptom, but it is also correlated with tumor location, size and depth, and is a prognostic factor for poor outcomes including overall survival and tumor relapse.

Extreme skeletal muscle loss during induction chemotherapy is an independent predictor of poor survival in advanced epithelial ovarian cancer patients

“…In addition to skeletal muscle loss, body weight loss derived from cancer cachexia and malnutrition is reported to be associated with a poor prognosis for several malignancies. [6][7][8][9][10] However, body weight loss was not associated with poor OS in our cohort. Skeletal muscle loss may be a more accurate prognostic marker than body weight loss because skeletal muscle loss and adipose tissue gain can occur simultaneously 13 ; consequently, body weight loss may not be reflected by sarcopenia status.…”

“…Our data support the findings regarding the prognostic significance of skeletal muscle loss during NAC in the population not including obese patients. In addition to skeletal muscle loss, body weight loss derived from cancer cachexia and malnutrition is reported to be associated with a poor prognosis for several malignancies 6–10 . However, body weight loss was not associated with poor OS in our cohort.…”

“…Peritoneal carcinomatosis in EOC patients results in systemic inflammation and malnutrition [1][2][3][4][5][6] with concomitant weight loss. 6,7 Weight loss is associated with a poor prognosis in several cancers, [6][7][8][9][10] as is sarcopenia, the severe loss of skeletal muscle. [11][12][13][14][15][16][17][18] Several studies report an association between skeletal muscle loss and poor prognosis specifically in ovarian cancer patients.…”

<p>Prognostic value of lactate dehydrogenase to albumin ratio (LAR) in patients with resectable esophageal squamous cell carcinoma</p>

“…However, the relation between ALB and WL remains controversial. Kuo et al22 reported WL was significantly associated with ALB in colon cancer patients. However, Unal et al23 revealed that there was no significant difference between the WL and ALB in patients with head and neck cancer.…”

The Role of the Small Bowel in Unintentional Weight Loss after Treatment of Upper Gastrointestinal Cancers

“…Unintentional weight loss is defined as >5% of body weight loss within 6–12 months. Malignancies, particularly GI cancers, are diagnosed in approximately 25% of patients who present with unintentional weight loss [13,14,15]. Moreover, the highest frequency of weight loss is seen among the patients with pancreatic or gastric cancer [16,17].…”