Índice de comorbidade de Charlson e sua associação com composição corporal e mortalidade global de pacientes recentemente diagnosticados com câncer colorretal: estudo longitudinal multicêntrico

Abstract

Cancer is one of the main causes of death in most countries, and in Brazil the context is similar. Of these, colorectal cancer (CRC) stands out with its high incidence. In addition to the diagnosis of cancer, the presence of comorbidities can impact the body composition and prognosis of these patients. Thus, knowing these characteristics is necessary to carry out interventions that will improve the quality and survival of this population. Therefore, the aim of this study was to analyze the relationship between age-adjusted Charlson comorbidity index (A-ICC) and body composition, as well as overall survival in patients newly diagnosed with CRC. This is a multicenter cohort study, which evaluated patients of both sexes, adults and elderly with a recent diagnosis of CRC followed for 36 months. Computed tomography (CT) images of the abdominal region were analyzed to determine body composition: skeletal muscle mass area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total adipose tissue (TAT). Comorbidities were recorded and scored. Approximately half of the patients (50.4%) had no comorbidity, and the most prevalent was uncomplicated diabetes mellitus (16.1%). The A-CCI median score was 4 (3;6). Cox regression adjusted by confounding variables indicated that patients classified as “high A-CCI and low SMA” had higher risk of 36-month mortality (HR = 1.53, 95% CI: 1.08 – 2.18), while the phenotypes “low A-CCI and high SMD” and “low A-CCI and low VAT” were associated with lower risk of 36-months mortality. In conclusion, our findings present an association between SMA, SMD, VAT and comorbidity burden in patients with CRC, with certain combinations of these characteristics potentially increasing mortality risk.