scholarly journals Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls

2022 ◽  
Author(s):  
Maria Lopez-Garzon ◽  
Paula Postigo-Martin ◽  
Ángela González-Santos ◽  
Manuel Arroyo-Morales ◽  
Alexander Achalandabaso-Ochoa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Composition ◽  
Cancer Pain ◽  
Lean Mass ◽  
Matched Control ◽  
Post Treatment ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Dominant Side

Abstract Background The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. Methods An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s d and Hedge’s effect size, as appropriate. Results The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). Conclusion Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.

scholarly journals Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 309
Author(s):  
Kun-Yun Yeh ◽  
Hang Huong Ling ◽  
Shu-Hang Ng ◽  
Cheng-Hsu Wang ◽  
Pei-Hung Chang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Head And Neck Cancer ◽  
Mass Loss ◽  
Lean Mass ◽  
Recurrence Free Survival ◽  
Skeletal Muscle Index ◽  
Free Survival ◽  
Prognostic Predictor ◽  
Appendicular Skeletal Muscle

Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT.

Abstract 17105: Is There a Difference in Lean and Fat Mass in HF Patients Based on NYHA Classifications (I-II versus III-IV)?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Christine Haedtke ◽  
Debra K Moser ◽  
Susan J Pressler ◽  
Terry Lennie
Keyword(s):  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Nyha Class ◽  
Class I ◽  
Unexpected Finding ◽  
Class Iii ◽  
Medication Regimen ◽  
Cross Sectional ◽  
Nyha Classification

Introduction: As NYHA Class increases from I (ordinary physical activity does not cause undue fatigue), to Class IV (Symptoms are present while at rest) physical limitations become severe. It has previously been shown that HF patients have increased fat within the muscle thus decreasing exercise performance and tolerance. It is unclear if all NYHA classes are similarly affected. Hypothesis: HF patients with NYHA class III-IV will have more fat and less lean mass than those with NYHA class I-II. Methods: Secondary data analysis using cross sectional data from N=253. The parent study was a multicenter study about nutrition and body composition among patients with HF (preserved or reduced, and NYHA classification I-IV) who had been on a stable medication regimen, able to participate in dual-energy X-ray absorptiometry scan and/or BodPod body composition measures, able to read and speak English, and had no cognitive impairment. Women and men were analyzed separately due to known differences in fat and lean mass. Results: Table 1: Sample characteristic’s Testing the hypothesis using 2-way ANOVA and comparing the percentage of body weight that is lean and fat mass in NYHA class I-II vs III-IV found the interaction of gender and NYHA was not significant in either % lean or %fat (p=0.221, 0.190 respectively). NYHA class by itself was not significant (p=0.067) in %lean but was significant in %fat (p=0.046). Gender was significant in both %lean and %fat with men having 9.6% less fat (1.139 SE) and 9.8% more lean mass (1.066 SE) (p≤0.001). NYHA class III-IV had 2.3% (1.139 SE) more fat than those in NYHA class I-II. The R squared was 0.265 and adjusted R squared was 0.256. Conclusions: Part of our hypothesis was correct in that NYHA class III-IV had more fat mass than those in class I-II, but no difference was found in lean. This is an unexpected finding as healthy people gain fat mass while losing lean mass as they age. Additional studies are needed to further examine this result.

scholarly journals The Relationship between Body Composition, Dietary Intake, Physical Activity, and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 310
Author(s):  
Kevin J. Scully ◽  
Laura T. Jay ◽  
Steven Freedman ◽  
Gregory S. Sawicki ◽  
Ahmet Uluer ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystic Fibrosis ◽  
Body Composition ◽  
Dietary Intake ◽  
Healthy Volunteers ◽  
Clinical Outcomes ◽  
Body Fat ◽  
Lean Mass ◽  
Cross Sectional ◽  
Adolescents And Adults

Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.

scholarly journals Change in skeletal muscle index and its prognostic significance in patients who underwent successful conversion therapy for initially unresectable colorectal cancer: observational study

2020 ◽  
Vol 13 ◽  
pp. 175628482097119
Author(s):  
Hiroaki Nozawa ◽  
Shigenobu Emoto ◽  
Koji Murono ◽  
Yasutaka Shuno ◽  
Kazushige Kawai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Systemic Therapy ◽  
Skeletal Muscles ◽  
Prognostic Significance ◽  
Stage Iv ◽  
The Body ◽  
Conversion Therapy ◽  
Cross Sectional ◽  
Skeletal Muscle Index

Background: Systemic therapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is unknown how the body composition is changed by chemotherapy rendering unresectable CRC to resectable disease or how it affects the prognosis. This study aimed at elucidating the effects of systemic therapy on skeletal muscles and survival in stage IV CRC patients who underwent conversion therapy. Methods: We reviewed 98 stage IV CRC patients who received systemic therapy in our hospital. According to the treatment setting, patients were divided into the conversion, neoadjuvant chemotherapy (NAC), and palliation groups. The cross-sectional area of skeletal muscles at the third lumbar level and changes in the skeletal muscle index (SMI), defined as the area divided by height squared, during systemic therapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the conversion group. Results: The mean SMI increased by 9.4% during systemic therapy in the conversion group ( n = 38), whereas it decreased by 5.9% in the NAC group ( n = 18) and 3.7% in the palliation group ( n = 42, p < 0.0001). Moreover, patients with increased SMI during systemic therapy had a better overall survival (OS) than those whose SMI decreased in the conversion group ( p = 0.025). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio 0.25). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. On the other hand, a decrease in the SMI during systemic therapy was a negative prognostic factor in such patients.

The impact of sarcopenia on toxicity and pharmacokinetics of 5-fluorouracil (5FU) in colorectal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 633-633 ◽  
Author(s):  
Grant Richard Williams ◽  
Allison Mary Deal ◽  
Shlomit S. Shachar ◽  
Christine Marie Walko ◽  
Jai Narendra Patel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Secondary Analysis ◽  
Cytotoxic Agents ◽  
Composition Analysis ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Grade 3 ◽  
The Impact

633 Background: Great heterogeneity exists in the ability of adults with cancer to tolerate treatment. Variability in body composition may affect rates of metabolism of cytotoxic agents and contribute to the variable chemotherapy toxicity observed. The goal of this study was to explore the impact of body composition, in particular sarcopenia, on the pharmacokinetics of 5-fluorouracil (5FU) in a cohort of patients receiving FOLFOX +/- bevacizumab for colorectal cancer. Methods: We performed a secondary analysis of a completed multicenter trial that investigated pharmacokinetic-guided 5FU in patients receiving mFOLFOX6 +/- bevacizumab [Patel et al. The Oncologist 2014]. Computed Tomography (CT) images that were performed as part of routine care were used to for body composition analysis. Skeletal muscle area (SMA) and density (SMD) were analyzed from CT scan L3 lumbar segments using radiological software. SMA and height (m2) were used to calculate skeletal muscle index (SMI = SMA/m2). Skeletal Muscle Gauge (SMG) was created by multiplying SMI x SMD. Differences were compared using two group t-tests and fisher’s exact tests. Results: Of the 70 patients from the original study, 25 had available CT imaging. The mean age was 59, 52% female, 80% Caucasian, and 92% with either stage III or IV disease. Eleven patients (44%) had grade 3/4 toxicity, and 12 patients were identified as sarcopenic (48%) [per Martin et al. JCO 2013]. Sarcopenic patients had numerically higher first cycle 5FU AUCs compared to non-sarcopenic patients (19.3 vs. 17.3 AUC, p= 0.43) and higher grade 3/4 toxicities (50 vs 38.5%, p= 0.70). Patients with low SMG ( < 1475 AU) had higher grade 3/4 toxicities (62 vs 25%, p= 0.11) and higher hematologic toxicities (46 v 8%, p= 0.07). Conclusions: CRC patients with sarcopenia had numerically higher first cycle AUCs of 5FU and a higher incidence of severe toxicities; however, this was not statistically significant, possibly due to limited sample size. SMG, an integrated muscle measure, was more highly correlated with toxicity outcomes than either SMI or SMD alone. Further research exploring the role of body composition in pharmacokinetics is needed with a focus on alternative dosing strategies in sarcopenic patients.

Association between pretreatment Fusobacterium nucleatum and cancer pain at six months postsurgery in newly diagnosed colorectal cancer patients: Results from the ColoCare Study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3581-3581
Author(s):  
Anita Roselyn Peoples ◽  
Biljana Gigic ◽  
Jennifer Ose ◽  
Andreana Natalie Holowatyj ◽  
Patrick M. Mallea ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Fusobacterium Nucleatum ◽  
Tumor Stage ◽  
Life Questionnaire ◽  
Newly Diagnosed ◽  
European Organization ◽  
Post Surgery ◽  
Colorectal Cancer Patients

3581 Background: Pain is a prevalent, debilitating symptom in more than half of cancer patients. Accumulating evidence suggests a bi-directional relationship between gut microbiota and pain, potentially via inflammation and oxidative stress. Fusobacterium nucleatum (Fn), a pro-inflammatory anaerobic bacterium, is frequently detected in colorectal cancer (CRC) patients. To date, no study has identified a relationship between Fn and cancer pain in CRC patients. We investigated the associations between pre-treatment Fn and cancer pain at 6 months post-surgery in CRC patients. Methods: We utilized pre-surgery stool samples collected from 80 prospectively followed, newly diagnosed CRC patients recruited from the German site of the international ColoCare Study. Eligible patients were neo-adjuvant treatment naïve and did not use antibiotics for at least 1 month before stool collection. Fn DNA was assessed via quantitative real-time polymerase chain reaction. Patients were median split into Fn-high (>17.27; n=40) or Fn-low (≤17.27; n=40). Cancer pain was assessed using the 2 pain symptom items from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-30 (lower score=lower pain) at pre- and 6 months post-surgery. Results: Before surgery, 48% of all patients reported any pain. At 6 months post-surgery, we observed a decrease in cancer pain by 33% for Fn-low, while there was an increase in cancer pain by 41% for Fn-high. After controlling for pre-surgery cancer pain in ANCOVA model, we observed significantly higher mean cancer pain at 6 months post-surgery in the Fn-high group vs. the Fn-low group (24.07 vs. 13.44; effect size, ES=0.45; p=0.04). These results were maintained even after controlling for age, sex, tumor stage and site, adjuvant chemotherapy, BMI, physical activity, and any pain medications (29.11 vs. 16.55; ES=0.53; p=0.03). Conclusions: These findings suggest that high Fn is an independent predictor of cancer pain at 6 months post-surgery in colorectal cancer patients. Further research is needed to confirm and understand the mechanisms of these results. Funding: NCI U01 CA206110.

Expression of the senescence biomarker p16INK4a among childhood, adolescent, and young adult cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 10556-10556
Author(s):  
Andrew Brian Smitherman ◽  
Vanessa L Ayer Miller ◽  
Natalia Mitin ◽  
Allison Mary Deal ◽  
Hyman B. Muss
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Cellular Senescence ◽  
Adolescent And Young Adult ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer

10556 Background: The mechanism of accelerated aging among survivors of childhood, adolescent, and young adult cancer is not clearly understood. Cellular senescence may contribute to this process. We measured peripheral blood T lymphocyte p16INK4a expression, a biomarker of cellular senescence and aging, among pediatric and young adult cancer survivors hypothesizing that p16INK4a expression is higher due to chemotherapy exposure and among frail survivors. Methods: Two cohorts were enrolled from January 2018 to December 2019 at an academic medical center. One, a cross-sectional cohort of young adult cancer survivors and age-matched, cancer-free controls in whom we assessed p16INK4a expression and clinical frailty. Frailty was measured with the modified Fried Frailty Index that evaluates skeletal muscle index, weakness, slowness, leisure energy expenditure, and exhaustion. A second cohort underwent prospective measurement of p16INK4a expression before and after cancer chemotherapy. Eligibility among survivors and newly diagnosed patients required treatment with an alkylating agent, an anthracycline / anthracenedione, or both. Multivariable linear regression was used to model expression of p16INK4a by patient age at assessment, treatment intensity, and frailty status. Results: The cross-sectional cohort enrolled 60 young adult survivors and 29 age-matched, cancer-free controls with median age 21 years and range 17-29 years for both groups. Survivors were a median of 5.5 years from end of treatment. The prospective cohort enrolled nine newly diagnosed patients (range 1-18 years). Expression of p16INK4a was higher among young adult cancer survivors as compared to age-matched controls (9.6 v. 8.9 log2 p16 units, p < 0.01) representing a 25-year age acceleration in the survivors. Expression of p16INK4a increased among newly diagnosed patients from matched pre- to post-treatment samples (7.3 to 8.9 log2 p16 units, p = 0.002). Nine survivors (16%) met criteria for being frail and had higher p16INK4a expression as compared to robust survivors (10.5 [frail] v. 9.5 [robust] log2 p16 units, p = 0.055). Conclusions: Chemotherapy is associated with increased cellular senescence in pediatric and young adult cancer survivors as reflected in expression of p16INK4a indicating an increase in molecular age following chemotherapy exposure. The large proportion of frail survivors in this study also exhibited higher levels of p16INK4a suggesting that cellular senescence may be associated with early aging observed among these survivors.

scholarly journals Association between anthropometric and physical data of university soccer players from different positions

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Sacha Clael Rodrigues Rêgo ◽  
Samuel da Silva Aguiar ◽  
Filipe Manuel Clemente ◽  
Ricardo Franco Lima ◽  
Gustavo De Conti Teixeira Costa ◽  
...  
Keyword(s):  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Positive Association ◽  
Fat Free Mass ◽  
Soccer Players ◽  
Cross Sectional ◽  
Recovery Test ◽  
Performance Variables ◽  
Sectional Analysis

The present study aimed to check if there is an association between fitness performance variables and to analyze the variation of fitness levels between playing positions university soccer players. Twenty university soccer players were selected (20.95 ± 1.84 years; 71.60 ± 11.65 kg; 176.85 ± 7.28 m) divided into defenders, midfielders and attackers. Body composition was assessed in a cross-sectional analysis that correlated fat mass, lean mass and fat-free mass by DXA with the physical capacity tests. The main results of the present study revealed that both 10-m and 20-m accelerations had moderate-to-large correlations with agility tests across the playing positions, however these accelerations were largely inversely correlated with YoYo intermittent recovery test in defenders and largely positively in midfielders. The agility test was moderately correlated with YoYo intermittent recovery test across the different playing positions. In conclusion, there the acceleration and the agility had a positive association with the different positions of the soccer players.

NIMG-26. IMPROVING THE GENERALIZABILITY OF DEEP LEARNING FOR T2-LESION SEGMENTATION OF GLIOMAS IN THE POST-TREATMENT SETTING

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi134-vi134
Author(s):  
Jacob Ellison ◽  
Francesco Caliva ◽  
Pablo Damasceno ◽  
Tracy Luks ◽  
Marisa LaFontaine ◽  
...  
Keyword(s):  
Deep Learning ◽  
Transfer Learning ◽  
Response Assessment ◽  
Training Transfer ◽  
Post Treatment ◽  
Treatment Setting ◽  
Newly Diagnosed ◽  
Lesion Segmentation ◽  
Cross Sectional ◽  
Segmentation Accuracy

Abstract Although current advances for automated glioma lesion segmentation and volumetric measurements using deep learning have yielded high performance on newly-diagnosed patients, response assessment in neuro-oncology still relies on manually-drawn, cross-sectional areas of the tumor because these models do not generalize to patients in the post-treatment setting, where they are most needed in the clinic. Surgical resections, adjuvant treatment, or disease progression can alter the characteristics of these lesions on T2-weighted imaging, causing measures of segmentation accuracy, typically measured by Dice coefficients of overlap (DCs), to drop by ~15%. To improve the generalizability of T2-lesion segmentation to patients with glioma post-treatment, we evaluated the effects of: 1) training with different proportions of newly-diagnosed and treated gliomas, 2) applying transfer learning from pre- to post-treatment domains, and 3) incorporating a loss term that spatially weights the lesion boundaries with greater emphasis in training. Using 425 patients (208 newly-diagnosed, 217 post-Tx, with 25 treated patients withheld as a test set) and a top-performing model previously trained on newly-diagnosed gliomas, we found that DCs increased by 10% (to 0.84) then plateaued after including ~25% of post-treatment patients in training. Transfer learning (pre-training on newly-diagnosed and finetuning with post-treatment data) significantly improved Hausdorf distances (HDs), a measure more sensitive to changes at the lesion boundaries, by 17% after including 26% post-treatment images in training, while DCs remained similar. Although modifying our loss functions with boundary-weighted penalizations resulted in comparable DCs to using standard DC loss, HD measures were further reduced by 26%, suggesting that HDs may be a more sensitive metric to subtle changes in segmentation accuracy than DCs. Current work is evaluating their utility in providing accurate volumes for real-time response assessment in the clinic using workflows that have recently been deployed on our clinical PACs system.

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