The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: A systematic review

G. Malietzis, O. Aziz, N. M. Bagnall, N. Johns, K. C. Fearon, J. T. Jenkins*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background Strong evidence indicates that excessive adipose tissue distribution or reduced muscle influence short-, mid-, and long-term colorectal cancer outcomes. Computerized tomography-based body composition (CTBC) analysis quantifies this in a reproducible parameter. We reviewed the evidence linking computerized tomography (CT) based quantification of BC with short and long-term outcomes in colorectal cancer (CRC). Methods A systematic review was performed according to PRISMA guidelines. A literature search was performed by two independent reviewers on all studies that included CTBC analysis in patients undergoing treatment for CRC using Medline, EMBASE, Google Scholar, and Cochrane databases. Outcomes of interest included short-term recovery, oncological outcomes, and survival. Results Seventy-five studies were identified; sixteen met the inclusion criteria. None were randomized controlled trials and all were cohort studies of small sample size. Several types of CTBC image analysis software were identified, reporting subcutaneous, visceral and skeletal muscle tissues. Visceral obesity and reduced muscle mass were categorical parameters quantified by CTBC analysis. Due to marked study heterogeneity, quantitative data synthesis was not possible. High visceral adipose tissue and reduced skeletal muscle resulted in poorer short-term recovery (eleven studies), poorer oncological outcomes (six studies), and poorer survival (six studies). Conclusions CTBC techniques may be linked to outcomes in colorectal cancer patients, however larger studies are required. CTBC based assessment may allow early identification of high-risk patients, allowing early optimisation of patients undergoing cancer treatments.

Original languageEnglish
Pages (from-to)186-196
Number of pages11
JournalEJSO - European Journal of Surgical Oncology
Volume41
Issue number2
Early online date3 Nov 2014
DOIs
Publication statusPublished - 1 Feb 2015

Keywords

  • Body composition
  • Colorectal cancer
  • Outcomes

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