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Associations of Abdominal Skeletal Muscle Mass, Fat Mass, and Mortality among Men and Women with Stage I-III Colorectal Cancer.

  • van Baar, Harm1
  • Winkels, Renate M2
  • Brouwer, Jesca G M1
  • Posthuma, Liesbeth1
  • Bours, Martijn J L3
  • Weijenberg, Matty P3
  • Boshuizen, Hendriek C1
  • van Zutphen, Moniek1
  • van Duijnhoven, Fränzel J B1
  • Kok, Dieuwertje E1
  • Wesselink, Evertine1
  • Slooter, Gerrit D4
  • Spillenaar Bilgen, Ernst J5
  • Hansson, Birgitta M E6
  • de Wilt, Johannes H W7
  • Kampman, Ellen1
  • Beijer, Sandra8
  • 1 Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands. , (Netherlands)
  • 2 Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands. [email protected] , (Netherlands)
  • 3 Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands. , (Netherlands)
  • 4 Department of Surgery, Maxima Medical Centre, Veldhoven, the Netherlands. , (Netherlands)
  • 5 Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands. , (Netherlands)
  • 6 Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands. , (Netherlands)
  • 7 Department of Surgery, Radboud Universitair Medisch Centrum, Nijmegen, the Netherlands. , (Netherlands)
  • 8 Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands. , (Netherlands)
Published Article
Cancer Epidemiology Biomarkers & Prevention
American Association for Cancer Research
Publication Date
May 01, 2020
DOI: 10.1158/1055-9965.EPI-19-1134
PMID: 32132148


The associations of abdominal skeletal muscle mass index (SMI), visceral and subcutaneous adipose tissue (VAT and SAT, respectively), and mortality among patients with stage I-III colorectal cancer may differ for men and women, but only few studies stratified their data into men and women. We investigated associations of abdominal SMI, VAT, and SAT with overall mortality among men and among women with stage I-III colorectal cancer. SMI, VAT, and SAT were assessed from abdominal CT images for 1,998 patients with stage I-III colorectal cancer diagnosed between 2006 and 2015. Restricted cubic splines (RCS) were used to investigate associations of SMI, VAT, and SAT with overall mortality. Average age of the participants was 67.9 ± 10.6 years and 58% were men. During a median follow-up of 4.3 years, 546 (27%) patients died. Among men, the association of SMI and mortality was statistically significant in a nonlinear way in the RCS analyses, with lower SMI levels associated with higher mortality. SMI was not associated with mortality among women. SAT was associated with mortality in a nonlinear way for men and for women, with lower SAT levels being associated with higher mortality. VAT was not significantly associated with mortality in men or women. Associations of abdominal skeletal muscle mass with mortality among patients with colorectal cancer were not the same for men and for women. This study stresses the importance for more attention on sex-related differences in body composition and cancer outcomes. ©2020 American Association for Cancer Research.

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