scholarly journals The relationship between cardiopulmonary exercise test variables, the systemic inflammatory response, and complications following surgery for colorectal cancer

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Stephen T. McSorley ◽  
Campbell S. D. Roxburgh ◽  
Paul G. Horgan ◽  
Donald C. McMillan
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Response ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Systemic Inflammatory Response ◽  
Cardiopulmonary Exercise ◽  
The Relationship

The relationship between systemic inflammation-based prognostic scores and body composition analysis in colorectal cancer patients.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 407-407
Author(s):  
Euan Douglas ◽  
Colin H. Richards ◽  
Campbell S. D. Roxburgh ◽  
Paul G. Horgan ◽  
Donald C. Mcmillan
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Inflammatory Response ◽  
Systemic Inflammation ◽  
Systemic Inflammatory Response ◽  
Prognostic Scores ◽  
Skeletal Muscle Index ◽  
Chronic Activation ◽  
Total Fat ◽  
The Relationship

407 Background: Weight loss in cancer is increasingly recognised as part of syndrome associated with chronic activation of the systemic inflammatory response (McMillan DC, 2009). The aim of the present study was to examine the relationship between systemic inflammation based prognostic scores (SIBPS) and CT measured parameters of body composition in patients with primary operable colorectal cancer (CRC). Methods: 303 patients with primary operable CRC who underwent resection with curative intent (2003-2012) were studied. Image analysis of CT scans was used to measure total fat index (cm2/m2), subcutaneous fat index (cm2/m2), visceral fat index (cm2/m2) and skeletal muscle index (cm2/m2). SIBPS included the Glasgow Prognostic Score (mGPS), Neutrophil: Lymphocyte ratio (NLR), Platelet: Lymphocyte Ratio (PLR), Prognostic Index (PI), and Prognostic Nutritional Index (PNI). Results: In all patients there was a significant association between lower BMI and skeletal muscle index and an elevated systemic inflammatory response, as measured by the mGPS (p=0.028 and p<0.001), NLR (p=0.004 and p=0.002), and PNI (p=0.001 and p=0.022). In male patients there was a significant association between lower BMI, total fat mass and skeletal muscle index and an elevated systemic inflammatory response, as measured by the mGPS (p= 0.027, p=0.048 and p=0.001), NLR (p=0.002, p=0.034 and p=0.003), and PNI (p=0.003, p<0.001 and p0.048). In female patients total body fat was associated with the PLR (p=0.001) and PNI (p=0.009) but only the mGPS (p=0.007) and the PI (p=0.013) were associated with reduced skeletal muscle. Conclusions: The present study highlights a consistent association between lower BMI and skeletal muscle mass and the presence of a systemic inflammatory response. These results are consistent with the hypothesis that chronic activation of the systemic inflammatory response results in the loss of lean tissue and that ultimately compromises survival in patients with CRC. McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care. 2009;12:223-6.

scholarly journals The Relationship between Imaging-Based Body Composition Analysis and the Systemic Inflammatory Response in Patients with Cancer: A Systematic Review

Cancers ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1304 ◽  
Author(s):  
Abbass ◽  
Dolan ◽  
Laird ◽  
McMillan
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Inflammatory Response ◽  
Systemic Inflammation ◽  
Systemic Inflammatory Response ◽  
Cochrane Library ◽  
Composition Analysis ◽  
Patients With Cancer ◽  
The Relationship

Background and aim: Cancer is the second leading cause of death globally. Nutritional status (cachexia) and systemic inflammation play a significant role in predicting cancer outcome. The aim of the present review was to examine the relationship between imaging-based body composition and systemic inflammation in patients with cancer. Methods: MEDLINE, EMBASE, Cochrane Library and Google Scholar were searched up to 31 March 2019 for published articles using MESH terms cancer, body composition, systemic inflammation, Dual energy X-ray absorptiometry (DEXA), magnetic resonance imaging (MRI), ultrasound sonography (USS) and computed tomography (CT). Studies performed in adult patients with cancer describing the relationship between imaging-based body composition and measures of the systemic inflammatory response were included in this review. Results: The literature search retrieved 807 studies and 23 met the final eligibility criteria and consisted of prospective and retrospective cohort studies comprising 11,474 patients. CT was the most common imaging modality used (20 studies) and primary operable (16 studies) and colorectal cancer (10 studies) were the most commonly studied cancers. Low skeletal muscle index (SMI) and systemic inflammation were consistently associated; both had a prognostic value and this relationship between low SMI and systemic inflammation was confirmed in four longitudinal studies. There was also evidence that skeletal muscle density (SMD) and systemic inflammation were associated (9 studies). Discussion: The majority of studies examining the relationship between CT based body composition and systemic inflammation were in primary operable diseases and in patients with colorectal cancer. These studies showed that there was a consistent association between low skeletal muscle mass and the presence of a systemic inflammatory response. These findings have important implications for the definition of cancer cachexia and its treatment.

Does pre-operative aspirin and statin prescription modulate the post-operative systemic inflammatory response following surgery for colorectal cancer?

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 596-596 ◽  
Author(s):  
David G. Watt ◽  
James Hugh Park ◽  
Shoukee K Ng ◽  
Paul G. Horgan ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Response ◽  
Elective Surgery ◽  
Systemic Inflammatory Response ◽  
Current Evidence ◽  
Reactive Protein ◽  
Statin Prescription ◽  
Short And Long Term ◽  
The Relationship

596 Background: Aspirin use has been reported to reduce the pre-op systemic inflammatory response (SIR) in patients with colorectal cancer (CRC). Moreover, an exaggerated post-op SIR, evidenced by C-reactive protein (CRP) concentrations, is associated with poorer short and long term outcomes, highlighting the importance of CRP as a potential therapeutic target for improving outcomes following surgery for CRC. Drugs such as corticosteroids, aspirin and statins may modulate the post-op SIR, but there is little current evidence supporting this hypothesis. Therefore, the aim of the present study was to determine whether pre-op prescription of aspirin or statins modulated the post-op SIR in patients undergoing surgery for CRC. Methods: Included patients were obtained from a prospectively maintained database of CRC resections from a single institution (2010-2014). The relationship between pre-op aspirin and statin prescription and post-op CRP concentrations was examined. Results: 446 patients were included. The majority of patients were > 65 yrs (64%), male (57%) and underwent elective surgery (91%). 120 patients were prescribed aspirin and 187 prescribed statins with 100 patients prescribed both. Patients prescribed aspirin had a reduced post-op SIR particularly on day 3 (p = 0.009), 4 (p = 0.003) and 5 (p = 0.005). This effect was also observed following elective surgery (n = 402) on day 3 (p = 0.014), day 4 (p = 0.009) and day 5 (p = 0.019). Patients prescribed a statin also had a reduced post-op SIR, particularly on days 3 (p = 0.010), 4 (p = 0.006) and 5 (p = 0.017) and also following elective surgery on day 3 (p = 0.039) and day 4 (p = 0.039). The combination of aspirin and statin, compared with none or each on its own, resulted in the lowest post-op SIR, particularly on day 3 (p = 0.015), day 4 (p = 0.006) and day 5 (p = 0.023). Conclusions: Pre-op prescription of aspirin or statins resulted in a reduced post-op SIR following surgery for CRC. Therefore, pre-op use of these medications may be of benefit in improving outcomes, by reducing the post-op SIR – a reported predictor of both long and short term outcomes, following surgery for CRC.

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