Prognostic Impact of Myosteatosis in Patients with Colorectal Cancer Undergoing Curative Surgery: an Updated Systematic Review and Meta-analysis

Overview

Journal Front Oncol

Specialty Oncology

Date 2024 Jul 4

PMID 38962266

Authors

Yu-Yao Chang

Bill Cheng

Affiliations

Soon will be listed here.

Abstract

Background: Colorectal cancer (CRC) is a global health concern, and identifying prognostic factors can improve outcomes. Myosteatosis is fat infiltration into muscles and is a potential predictor of the survival of patients with CRC.

Methods: This systematic review and meta-analysis aimed to assess the prognostic role of myosteatosis in CRC. PubMed, Embase, and Cochrane CENTRAL were searched up to 1 August 2023, for relevant studies, using combinations of the keywords CRC, myosteatosis, skeletal muscle fat infiltration, and low skeletal muscle radiodensity. Case-control, prospective, and retrospective cohort studies examining the association between myosteatosis and CRC outcomes after curative intent surgery were eligible for inclusion. Primary outcomes were overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS).

Results: A total of 10 studies with a total of 9,203 patients were included. The pooled hazard ratio (HR) for OS (myosteatosis vs. no myosteatosis) was 1.52 [95% confidence interval (CI), 1.38-1.67); for CSS, 1.67 (95% CI, 1.40-1.99); and for DFS, 1.89 (95% CI, 1.35-2.65).

Conclusion: In patients with CRC undergoing curative intent surgery, myosteatosis is associated with worse OS, CSS, and DFS. These findings underscore the importance of evaluating myosteatosis in patients with CRC to improve outcomes.

Citing Articles

A Scoping Review of the Implications and Applications of Body Composition Assessment in Locally Advanced and Locally Recurrent Rectal Cancer.

Mai D, Drami I, Pring E, Gould L, Rai J, Wallace A Cancers (Basel). 2025; 17(5).

PMID: 40075693 PMC: 11899338. DOI: 10.3390/cancers17050846.

References

Wang Y, Tian G, Chen S, Li N . Myosteatosis reduces overall survival in patients with digestive system malignancies: a meta-analysis with trial sequential analysis. Nutr Res. 2021; 94:25-33. DOI: 10.1016/j.nutres.2021.08.003. View

Aro R, Makarainen-Uhlback E, Ammala N, Rautio T, Ohtonen P, Saarnio J . The impact of sarcopenia and myosteatosis on postoperative outcomes and 5-year survival in curatively operated colorectal cancer patients - A retrospective register study. Eur J Surg Oncol. 2020; 46(9):1656-1662. DOI: 10.1016/j.ejso.2020.03.206. View

Park I, Yang S, Chung E, Cho E, Lee H, Shin S . Skeletal muscle gauge as a prognostic factor in patients with colorectal cancer. Cancer Med. 2021; 10(23):8451-8461. PMC: 8633260. DOI: 10.1002/cam4.4354. View

Miljkovic I, Vella C, Allison M . Computed Tomography-Derived Myosteatosis and Metabolic Disorders. Diabetes Metab J. 2021; 45(4):482-491. PMC: 8369205. DOI: 10.4093/dmj.2020.0277. View

Hossain M, Karuniawati H, Jairoun A, Urbi Z, Ooi D, John A . Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies. Cancers (Basel). 2022; 14(7). PMC: 8996939. DOI: 10.3390/cancers14071732. View

Kroenke C, Prado C, Meyerhardt J, Weltzien E, Xiao J, Cespedes Feliciano E . Muscle radiodensity and mortality in patients with colorectal cancer. Cancer. 2018; 124(14):3008-3015. PMC: 6033621. DOI: 10.1002/cncr.31405. View

Feng S, Mu H, Hou R, Liu Y, Zou J, Zhao Z . Prognostic value of myosteatosis in patients with lung cancer: a systematic review and meta-analysis. Int J Clin Oncol. 2022; 27(7):1127-1138. DOI: 10.1007/s10147-022-02181-1. View

Cao H, Gong Y, Wang Y . The prognostic impact of myosteatosis on overall survival in gynecological cancer patients: A meta-analysis and trial sequential analysis. Int J Cancer. 2022; 151(11):1997-2003. DOI: 10.1002/ijc.34179. View

van Baar H, Beijer S, Bours M, Weijenberg M, van Zutphen M, van Duijnhoven F . Low radiographic muscle density is associated with lower overall and disease-free survival in early-stage colorectal cancer patients. J Cancer Res Clin Oncol. 2018; 144(11):2139-2147. DOI: 10.1007/s00432-018-2736-z. View

10.

Cho M, Lee S, Song S . A Review of Sarcopenia Pathophysiology, Diagnosis, Treatment and Future Direction. J Korean Med Sci. 2022; 37(18):e146. PMC: 9091430. DOI: 10.3346/jkms.2022.37.e146. View

11.

Aleixo G, Shachar S, Nyrop K, Muss H, Malpica L, Williams G . Myosteatosis and prognosis in cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol. 2019; 145:102839. DOI: 10.1016/j.critrevonc.2019.102839. View

12.

Chen W, Shen Z, Zhang F, Zhang X, Chen W, Yan X . Prognostic value of myosteatosis and sarcopenia for elderly patients with colorectal cancer: A large-scale double-center study. Surgery. 2022; 172(4):1185-1193. DOI: 10.1016/j.surg.2022.05.031. View

13.

Franco Valle K, Lubner M, Pickhardt P . Computed Tomography Assessment of Sarcopenic Myosteatosis for Predicting Overall Survival in Colorectal Carcinoma: Systematic Review. J Comput Assist Tomogr. 2022; 46(2):157-162. DOI: 10.1097/RCT.0000000000001281. View

14.

Okugawa Y, Kitajima T, Yamamoto A, Shimura T, Kawamura M, Fujiwara T . Clinical Relevance of Myopenia and Myosteatosis in Colorectal Cancer. J Clin Med. 2022; 11(9). PMC: 9100218. DOI: 10.3390/jcm11092617. View

15.

Trejo-Avila M, Bozada-Gutierrez K, Valenzuela-Salazar C, Herrera-Esquivel J, Moreno-Portillo M . Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2021; 36(6):1077-1096. DOI: 10.1007/s00384-021-03839-4. View

16.

Aro R, Merilainen S, Sirnio P, Vayrynen J, Pohjanen V, Herzig K . Sarcopenia and Myosteatosis Are Associated with Neutrophil to Lymphocyte Ratio but Not Glasgow Prognostic Score in Colorectal Cancer Patients. J Clin Med. 2022; 11(9). PMC: 9104763. DOI: 10.3390/jcm11092656. View

17.

Czigany Z, Kramp W, Bednarsch J, van der Kroft G, Boecker J, Strnad P . Myosteatosis to predict inferior perioperative outcome in patients undergoing orthotopic liver transplantation. Am J Transplant. 2019; 20(2):493-503. DOI: 10.1111/ajt.15577. View

18.

Murnane L, Forsyth A, Koukounaras J, Pilgrim C, Shaw K, Brown W . Myosteatosis predicts higher complications and reduced overall survival following radical oesophageal and gastric cancer surgery. Eur J Surg Oncol. 2021; 47(9):2295-2303. DOI: 10.1016/j.ejso.2021.02.008. View

19.

Martin L, Gioulbasanis I, Senesse P, Baracos V . Cancer-Associated Malnutrition and CT-Defined Sarcopenia and Myosteatosis Are Endemic in Overweight and Obese Patients. JPEN J Parenter Enteral Nutr. 2019; 44(2):227-238. DOI: 10.1002/jpen.1597. View

20.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View