Grant Number:	4R01CA175011-04 Interpret this number
Primary Investigator:	Caan, Bette
Organization:	Kaiser Foundation Research Institute
Project Title:	Body Composition, Weight, and Colon Cancer Survival
Fiscal Year:	2016

DESCRIPTION (provided by applicant): Epidemiologic and scientific research shows that obesity has a significant influence on the risk of developing colorectal cancer. However, associations between adiposity and colorectal cancer (CRC) prognosis are less convincing. While some studies have found severely obese patients (BMI, e35 kg/m2) to have an increased risk of recurrence and/or death, most studies have found no association between body mass index (BMI) or weight gain after diagnosis and CRC prognosis. The lack of consistent findings between BMI and colorectal cancer endpoints may be due in part to the fact that BMI may be a poor surrogate for body composition in the context of illness. Adipose tissue and muscle mass exert powerful but different endocrine, immune, and hormonal influences within the body. Though overweight persons tend to have both higher amounts of lean and fat mass, low levels of muscle mass may be present in overweight or obese people; sarcopenia (muscle wasting) is common among cancer survivors, even in the presence of fat gain. Therefore, we propose to use abdominal CT scans collected as part of routine staging and surveillance both at diagnosis and 1-2 years after diagnosis, to assess fat and muscle mass and to examine the relationship of body composition to CRC survival in a cohort of persons (n=3546) diagnosed between 2005 and 2010 with Stage I-III invasive colorectal cancer (CRC) at Kaiser Permanente Northern California (KPNC). Specifically, we will examine the level of muscle wasting (sarcopenia) and excess fat mass (FM) in CRC survivors at diagnosis (Aim 1), the association between FM and muscle mass at diagnosis and CRC survival (Aim 2), whether changes in FM and muscle mass measured between diagnosis and 1 to 2 years after diagnosis vary by weight change post-diagnosis (Aim 3), and whether changes in FM and muscle mass measured between diagnosis and 1 to 2 years after diagnosis are associated with CRC survival (Aim 4). This study uses a novel, state-of-the art tool to collect more accurate measures of body composition than standard measures of height and weight, and could provide important insight into the role of energy balance and body composition in cancer survival. This study will enable identification of CRC patients who are at high risk for muscle wasting and may improve our understanding of why BMI is related to incident CRC but not CRC outcomes. The use of CT scans to assess fat/muscle mass could easily be done in the clinical or epidemiologic setting, adding an important physiologic measure to BMI to help target and personalize weight control strategies and other treatments to prevent muscle mass loss, potentially improving survival. Findings from this study may thus lead to altered clinical practice. Additionally, insights regarding the role of fat/muscle mass in CRC prognosis may provide new avenues for future research about the role of energy balance in cancer survival




Postoperative chemotherapy relative dose intensity and overall survival in patients with colon cancer.
Authors: Brown J.C. , Meyerhardt J.A. , Yang S. , Caan B.J. .
Source: Cancer Chemotherapy And Pharmacology, 2024-03-23 00:00:00.0; , .
EPub date: 2024-03-23 00:00:00.0.
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Authors: Brown J.C. , Meyerhardt J.A. , Cespedes Feliciano E.M. , Cheng E. , Caan B.J. .
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Scaling of computed tomography body composition to height: relevance of height-normalized indices in patients with colorectal cancer.
Authors: Brown J.C. , Heymsfield S.B. , Caan B.J. .
Source: Journal Of Cachexia, Sarcopenia And Muscle, 2021-11-06 00:00:00.0; , .
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Abdominal adipose tissue radiodensity is associated with survival after colorectal cancer.
Authors: Feliciano E.M.C. , Winkels R.M. , Meyerhardt J.A. , Prado C.M. , Afman L.A. , Caan B.J. .
Source: The American Journal Of Clinical Nutrition, 2021-09-12 00:00:00.0; , .
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Association of Low Muscle Mass and Low Muscle Radiodensity With Morbidity and Mortality for Colon Cancer Surgery.
Authors: Xiao J. , Caan B.J. , Cespedes Feliciano E.M. , Meyerhardt J.A. , Peng P.D. , Baracos V.E. , Lee V.S. , Ely S. , Gologorsky R.C. , Weltzien E. , et al. .
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Authors: Dabiri S. , Popuri K. , Ma C. , Chow V. , Feliciano E.M.C. , Caan B.J. , Baracos V.E. , Beg M.F. .
Source: Computerized Medical Imaging And Graphics : The Official Journal Of The Computerized Medical Imaging Society, 2020 Oct; 85, p. 101776.
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Authors: Cespedes Feliciano E.M. , Popuri K. , Cobzas D. , Baracos V.E. , Beg M.F. , Khan A.D. , Ma C. , Chow V. , Prado C.M. , Xiao J. , et al. .
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The Association of Abdominal Adiposity with Mortality in Patients with Stage I-III Colorectal Cancer.
Authors: Brown J.C. , Caan B.J. , Prado C.M. , Feliciano E.M.C. , Xiao J. , Kroenke C.H. , Meyerhardt J.A. .
Source: Journal Of The National Cancer Institute, 2019-07-29 00:00:00.0; , .
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Muscle segmentation in axial computed tomography (CT) images at the lumbar (L3) and thoracic (T4) levels for body composition analysis.
Authors: Dabiri S. , Popuri K. , Cespedes Feliciano E.M. , Caan B.J. , Baracos V.E. , Beg M.F. .
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The association of medical and demographic characteristics with sarcopenia and low muscle radiodensity in patients with nonmetastatic colorectal cancer.
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The evolution of body composition in oncology-epidemiology, clinical trials, and the future of patient care: facts and numbers.
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Non-alcoholic fatty liver disease and colorectal cancer survival.
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Associations of pre-existing co-morbidities with skeletal muscle mass and radiodensity in patients with non-metastatic colorectal cancer.
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Screening for low muscularity in colorectal cancer patients: a valid, clinic-friendly approach that predicts mortality.
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