The Effect and Mechanism of Subcutaneous and Visceral Adipose Tissue Loss on Gastric Cancer Patients With Cachexia

Weight loss leading to cachexia is associated with poor treatment response and reduced survival in pancreatic cancer patients. We aim to identify indicators that allow for early detection that will advance our understanding of cachexia and will support targeted anti-cachexia therapies. A total of fifty pancreatic cancer patients were analysed for skeletal muscle and visceral adipose tissue (VAT) changes using computed tomography (CT) scans. These changes were related to physical characteristics, secondary disease states and treatment parameters. Overall, patients lost 1·72 (sd 3·29) kg of muscle and 1·04 (sd 1·08) kg of VAT during the disease trajectory (413 (sd 213) d). After sorting patients into tertiles by rate of VAT and muscle loss, patients losing VAT at > − 0·40 kg/100 d had poorer survival outcomes compared with patients with < − 0·10 kg/100 d of VAT loss (P= 0·020). Patients presenting with diabetes at diagnosis demonstrated significantly more and accelerated VAT loss compared with non-diabetic patients. In contrast, patients who were anaemic at the first CT scan lost significantly more muscle tissue and at accelerated rates compared with non-anaemic patients. Accelerated rates of VAT loss are associated with reduced survival. Identifying associated features of cachexia, such as diabetes and anaemia, is essential for the early detection of cachexia and may facilitate the attenuation of complications associated with cachexia.

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The Association of Abdominal Adiposity With Mortality in Patients With Stage I–III Colorectal Cancer

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz150 ◽

2019 ◽

Vol 112 (4) ◽

pp. 377-383 ◽

Cited By ~ 6

Author(s):

Justin C Brown ◽

Bette J Caan ◽

Carla M Prado ◽

Elizabeth M Cespedes Feliciano ◽

Jingjie Xiao ◽

...

Keyword(s):

Colorectal Cancer ◽

Adipose Tissue ◽

Cancer Patients ◽

Visceral Adipose Tissue ◽

Subcutaneous Adipose Tissue ◽

Colorectal Cancer Patients ◽

Subcutaneous Adiposity ◽

Visceral Adipose ◽

Subcutaneous Adipose ◽

Shaped Pattern

Abstract Background The quantity and distribution of adipose tissue may be prognostic measures of mortality in colorectal cancer patients, and such associations may vary by patient sex. Methods This cohort included 3262 stage I–III colorectal cancer patients. Visceral and subcutaneous adipose tissues were quantified using computed tomography. The primary endpoint was all-cause mortality. Restricted cubic splines estimated statistical associations with two-sided P values. Results Visceral adipose tissue was prognostic of mortality in a reverse L-shaped pattern (nonlinear P = .02); risk was flat to a threshold (∼260 cm2) then increased linearly. Subcutaneous adipose tissue was prognostic of mortality in a J-shaped pattern (nonlinear P < .001); risk was higher at extreme (<50 cm2) but lower at intermediate values (>50 to ≤560 cm2). Patient sex modified the prognostic associations between visceral adipose tissue (Pinteraction = .049) and subcutaneous adipose tissue (Pinteraction = .04) with mortality. Among men, visceral adiposity was associated with mortality in a J-shaped pattern (nonlinear P = .003), whereas among women, visceral adiposity was associated with mortality in a linear pattern (linear P = .008). Among men, subcutaneous adiposity was associated with mortality in an L-shaped pattern (nonlinear P = .01), whereas among women, subcutaneous adiposity was associated with mortality in a J-shaped pattern (nonlinear P < .001). Conclusions Visceral and subcutaneous adipose tissue were prognostic of mortality in patients with colorectal cancer; the shape of these associations were often nonlinear and varied by patient sex. These results offer insight into the potential biological mechanisms that link obesity with clinical outcomes in patients with cancer, suggesting that the dysregulated deposition of excess adiposity is prognostic of mortality.

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