Serum tumor marker and CT body composition scoring system predicts outcomes in colorectal cancer surgical patients

作者：Mingming Song, Zhihao Liu, Feihong Wu, Tong Nie, Yixin Heng, Jiaxin Xu, Ning Huang, Xiaoyu Wu, Yinghao Cao, Gang Hu · 发表于：European Radiology · 年份：2024 · DOI：10.1007/s00330-024-10849-7 · 被引用次数：14 · 研究领域：Nutrition and Health in Aging、Body Composition Measurement Techniques、Inflammatory Biomarkers in Disease Prognosis

OBJECTIVE: To investigate the prognostic value of preoperative body composition and serum tumor markers (STM) in patients undergoing surgical treatment for colorectal cancer (CRC) and to establish the prognostic score for patients with CRC. METHODS: This study enrolled 365 patients (training set 245, validation set 120) with CRC who underwent surgical resection. The predictive value of various body composition features and STM for determining CRC prognosis were compared. A novel index score based on the independent risk factors from Cox regression for CRC patients was established and evaluated for its usefulness. RESULTS: Multivariate Cox regression showed that low skeletal muscle radiodensity (SMD) (p = 0.020), low subcutaneous fat area (SFA) (p = 0.029), high carcinoembryonic antigen (CEA) (p = 0.008), and high alpha-fetoprotein (AFP) (p = 0.039) were all independent prognostic factors for poor overall survival (OS). The multifactorial analysis indicated that high intermuscular fat area (IMFA) (p = 0.033) and high CEA (p = 0.009) were independent prognostic factors for poor disease-free survival (DFS). Based on these findings, two scoring systems for OS and DFS were established in the training datasets. CRC patients who scored higher on the new scoring systems had lower OS and DFS (both p < 0.001) as shown in the Kaplan-Meier survival curves in the training and validation datasets. CONCLUSION: In predicting the prognosis of CRC patients, SFA and SMD are superior to other bo...