Associação entre a composição muscular da musculatura da coxa com mortalidade em pacientes recém-diagnosticados com câncer colorretal

Abstract

Introduction: Colorectal cancer (CRC) is one of the main causes of morbidity and mortality worldwide. Patients with RCC often have low skeletal muscle mass associated with a worse prognosis. Objectives: To verify associations between thigh muscle parameters, assessed by computed tomography (CT) images, and adverse outcomes in patients with RCC. Methods: This multicenter cohort study with retrospective data collection, including adults (> 18 years). Thigh muscle parameters were analyzed in patients newly diagnosed with RCC, using CT as the evaluation method. CT images were analyzed to assess skeletal muscle (SM in cm²), skeletal muscle index (SMI in cm²/m²), and skeletal muscle density (SMD in HU). Muscle abnormalities (low SM, low SMI, and low SMD) were defined as values below the median by gender. Results: A total of 257 patients were included in the final analysis. The mean age of the patients was 62.6 ± 12.1 years and 50.2% (n = 129) were female. Kaplan-Meyer curves and hazard ratios (HR) for low MWS, MFS, and DFS were evaluated for overall mortality, stratified by sex. In men, low SMI of the thigh was associated with a 50% lower probability of survival (log-rank p = 0.02). In addition, low SMI (cm2/m2) was independently associated with higher mortality rates (adjusted HR 2.08, 95% CI 1.03 to 4.18). The outcome relating to clinical TNM stages, low MDS was independently associated with mortality in stages I-III (adjusted HR 2.78, 95% CI 1.26 to 6.15). Conclusion: Analyses of thigh muscle parameters using CT images showed an association between SMI parameters and MDS with overall mortality in patients newly diagnosed with RCC.