Supportive Care in Cancer

, Volume 23, Issue 3, pp 687–694 | Cite as

Effect of muscle mass on toxicity and survival in patients with colon cancer undergoing adjuvant chemotherapy

  • Hee-Won Jung
  • Jin Won Kim
  • Ji-Yeon Kim
  • Sun-Wook Kim
  • Hyun Kyung Yang
  • Joon Woo Lee
  • Keun-Wook Lee
  • Duck-Woo Kim
  • Sung-Bum Kang
  • Kwang-il Kim
  • Cheol-Ho Kim
  • Jee Hyun KimEmail author
Original Article



The purpose of this study was to elucidate the effect of decreased muscle mass on the toxicity and survival of patients with colon cancer treated with adjuvant chemotherapy after surgery.


We reviewed the data of 229 consecutive patients with stage III colon cancer who received adjuvant oxaliplatin, 5-fluorouracil, and leucovorin chemotherapy at a single center between 2003 and 2010. Baseline muscle mass was assessed by measuring the cross-sectional area of the psoas muscle at the level of the fourth lumbar vertebra on computed tomography images. Effects of muscle mass on toxicity of chemotherapy and survival were assessed.


The median age of the 229 patients was 61 years (range, 28–80) and 134 (58.5 %) were men. The mean psoas muscle mass index (PI, psoas muscle area divided by height2 [mm2/m2]) was 548.3. A 1 SD decrement in the PI was associated with an increase in all grade 3–4 toxicities in univariate (OR = 1.69, 95 % CI = 1.18–2.27) and multivariate (OR = 1.56, 95 % CI = 1.05–2.38) analyses. In univariate analysis, the PI was not associated with overall survival. However, multivariate analysis showed that a 1 SD decrement in the PI increased the hazard of overall mortality by 85 % (HR = 1.85, 95 % CI = 1.10–3.13). This effect of the PI on mortality was maintained in subgroup analyses, especially in older and obese patients.


Decreased muscle mass was associated with increased risk of grade 3–4 toxicity and poor prognosis in patients with stage III colon cancer.


Colon cancer Toxicity Mortality Sarcopenia 



Sources of funding

This study was supported in part by grant number 02-2014-046 from the SNUBH Research Fund and by study number 1320370 from the National R&D Program for Cancer Control, Ministry for Health and Welfare, Republic of Korea.

Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hee-Won Jung
    • 1
  • Jin Won Kim
    • 1
  • Ji-Yeon Kim
    • 1
  • Sun-Wook Kim
    • 1
  • Hyun Kyung Yang
    • 2
  • Joon Woo Lee
    • 2
  • Keun-Wook Lee
    • 1
  • Duck-Woo Kim
    • 3
  • Sung-Bum Kang
    • 3
  • Kwang-il Kim
    • 1
  • Cheol-Ho Kim
    • 1
  • Jee Hyun Kim
    • 1
    Email author
  1. 1.Division of Hematology and Medical Oncology, Department of Internal MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineBundang-gu, SeongnamSouth Korea
  2. 2.Department of RadiologySeoul National University Bundang Hospital, Seoul National University College of MedicineBundang-gu, SeongnamSouth Korea
  3. 3.Department of SurgerySeoul National University Bundang Hospital, Seoul National University College of MedicineBundang-gu, SeongnamSouth Korea

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