Combined test of third lumbar skeletal muscle index and prognostic nutrition index improve prognosis prediction power in resected colorectal cancer liver metastasis

Aging (Albany NY). 2019 Nov 22;11(22):10301-10315. doi: 10.18632/aging.102457. Epub 2019 Nov 22.

Abstract

Background: In this paper, we aim to explore clinical value of skeletal muscle index (SMI) and prognostic nutrition index (PNI) on resected colorectal cancer liver metastasis (CRLM).

Results: Among the 539 patients, 355 were males. Baseline lower SMI was associated with smaller BMI, smaller PNI, smaller pre-albumin and longer hospitalization days (P<0.05). Patients with lower SMI and PNI had significantly shorter duration of PFS and OS (P<0.05). SMI can reflect the postoperative treatment response. Postoperative 6-month's and 12-month's SMI and PNI can indicate overall prognosis. When combined SMI and PNI, prognostic AUC of ROC curves improved significantly.

Conclusion: Combined monitor of SMI and PNI can improve the power at predicting prognosis. Postoperative 6-month's record of SMI and PNI was more accurate and predictive for CRLM prognosis.

Method: A total of 539 resected CRLM patients between January 2013 to December 2016 with complete clinical data were included. Computed tomography image was collected from each patient. Receiver-operating characteristic (ROC) curves were constructed; area under curves (AUC) were also determined. All clinical variables were analyzed in proper way.

Keywords: colorectal cancer liver metastasis; prognosis; prognostic nutrition index; skeletal muscle index.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Back Muscles / diagnostic imaging*
  • Back Muscles / pathology
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Female
  • Humans
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / secondary*
  • Lumbosacral Region
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutritional Status
  • Prognosis
  • Serum Albumin / analysis*
  • Tomography, X-Ray Computed

Substances

  • Serum Albumin