Body composition and colorectal cancer recurrence and survival

Colorectal cancer patients who are obese or underweight may have a higher chance of recurrence of cancer, or of dying in comparison to patients of normal weight. However, data are sparse and inconsistent. Part of the inconsistency may be explained by differences in body composition: body fatness is often mainly assessed as body mass index (BMI), which does not give information about a persons' fat and or muscle mass. Excess fat mass in combination with low muscle mass – sarcopenic obesity - has been related to worse survival in comparison with persons who do not have a low muscle mass. These findings underline the need to study the associations of muscle and fat mass both separately and combined with recurrence and survival. Within the current proposal, these associations will be studied.



The study will be performed in The Netherlands

There are three main hypotheses:

1.visceral adiposity is associated with increased risk of recurrence and with decreased survival,

2.indicators of low muscle quality (low muscle mass, low muscle attenuation and increased inter-muscular fat areas) are associated with decreased survival,

3.indicators of low muscle quality are associated with decreased survival independent of adipose tissue area, but not with recurrence

Overall mortality and recurrence data will be updated for every paper

Data from two ongoing prospective cohort studies are combined with registry-based data from three hospitals. The prospective cohorts, i.e., the COLON (and EnCoRe studies, started in 2010 and 2012, respectively. For the registry-based data the Netherlands Cancer Registry is used to select all stage I-III CRC patients diagnosed between 2007 and 2013.