P309 - A NEW PREOPERATIVE CACHEXIA INDEX CAN PREDICT SURVIVAL IN COLORECTAL CANCER PATIENTS: A RETROSPECTIVE STUDY

P309

A NEW PREOPERATIVE CACHEXIA INDEX CAN PREDICT SURVIVAL IN COLORECTAL CANCER PATIENTS: A RETROSPECTIVE STUDY

T. Huaytalla¹, C. D'Almeida^1,*, L. B. Murad², W. Peres³

¹Nutrition and Dietetic Service, ²Basic Research, National Cancer Institute Brazil, ³Nutrition, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

Rationale: Colorectal cancer (CRC) is responsible for the second leading cause of cancer death worldwide and has a high prevalence of cachexia. The aim of this study was to investigate the impact of a new prognostic marker on overall survival (OS) in patients with colorectal cancer (CRC) in the preoperative period and to evaluate whether the use of skeletal muscle radiodensity (SMD), in a modified version of the cachexia index (CXI), would have a prognostic value.

Methods: Retrospective cohort study with CRC patients of both sexes treated at a hospital unit, aged ≥20 years. Data were extracted between 2007 and 2015. Survival functions were determined using the Kaplan-Meier method, and the Log-rank test was employed to compare the probability of survival. Multivariate Cox's models were employed to predict OS utilizing a cachexia index (CXI= skeletal muscle index (cm²/m²) × serum albumin (g/dL)/neutrophil–lymphocyte ratio) and a new cachexia index, modified CXI (mCXI= SMD (Hounsfield units) × serum albumin (g/dL)]/neutrophil–lymphocyte ratio). In addition, a Harrell concordance statistic (c) was used to assess the discriminatory ability of the models to predict OS.

Results: A total of 152 CRC patients with a mean age of 63.28 (standard deviation 12.73) years were evaluated. In this study, we calculated the CXI and a new cachexia index, mCXI, with SMD (fat infiltrated muscle), albumin, and NLR: three cachexia-related parameters. In multivariate analysis, the model with low CXI (HR: 1.89; 95% CI: 1.01-3.55; p= 0.046) and model 2, low mCXI (HR: 2.11; 95% CI: 1.13-3.95; p= 0.019) were independent predictors of a shorter OS. Both models had the same area under the ROC curve (C-statistic: 0.75) with good discrimination and predictive value. 

Conclusion: CXI and mCXI, using muscle quality, were independent predictors of a worse OS in patients with preoperative CRC.

Disclosure of Interest: None declared