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Impact of sarcopenia in patients with advanced or recurrent colorectal cancer treated with regorafenib

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Abstract

Background

Regorafenib is a key agent for patients with advanced or recurrent colorectal cancer. Sarcopenia represented by skeletal muscle depletion is closely related to frailty and predicts oncological prognoses. We hypothesized that sarcopenia negatively affects the time to treatment failure (TTF) or overall survival (OS) of patients treated with regorafenib.

Methods

We retrospectively reviewed the medical records of all patients treated with regorafenib between May 2013 and April 2019 at our institution. The cross-sectional area of the psoas muscle at the level of the third lumbar vertebra on baseline computed tomography (CT) was assessed to calculate the psoas muscle index (PMI). Sarcopenia was defined based on PMI cut-off values for Asian adults (6.36 cm2/m2 for males and 3.92 cm2/m2 for females).

Results

Thirty-four patients were analyzed. The prevalence of sarcopenia was 44.1%. Sarcopenia was significantly associated with poorer OS (median 3.2 vs. 5.3 months, p = 0.031). Less 75% 1-Month Relative Dose Intensity patients experienced significantly shorter TTF and OS than the rest, as did patients receiving total regorafenib dose of < 3360 mg (median 3.1 and 9.4 months, p < 0.001). Multivariate analysis showed that sarcopenia was a significant predictor of prognosis.

Conclusion

Sarcopenia was a predictive marker of negative outcome for patients with advanced or recurrent colorectal cancer treated with regorafenib. Screening for sarcopenia can be used to identify patients more likely to benefit from regorafenib in routine clinical practice.

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Authors and Affiliations

  1. Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, E21-19, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yasushi Murachi, Daisuke Sakai, Chiaki Inagaki, Naohiro Nishida, Toshifumi Yamaguchi & Taroh Satoh

  2. Division of Systems Biology, Nagoya University Graduate School of Medicine, 65 (710), Turumaichyo, Shouwa ku, Nagoya, Aichi, 466-8550, Japan

    Jun Koseki

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  1. Yasushi Murachi
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Correspondence to Daisuke Sakai.

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Murachi, Y., Sakai, D., Koseki, J. et al. Impact of sarcopenia in patients with advanced or recurrent colorectal cancer treated with regorafenib. Int J Clin Oncol 26, 409–416 (2021). https://doi.org/10.1007/s10147-020-01805-8

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  • DOI: https://doi.org/10.1007/s10147-020-01805-8

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