Age-adjusted Charlson comorbidity index and its association with body composition and overall survival in patients with colorectal cancer

• Published in: Supportive care in cancer 2024-08, Vol.32 (8), p.517, Article 517
• Main Authors: de Oliveira Bezerra, Mara Rúbia, de Sousa, Iasmin Matias, Miranda, Ana Lúcia, Ferreira, Glaucia Mardrini Cassiano, Chaves, Gabriela Villaça, Verde, Sara Maria Moreira Lima, Maurício, Silvia Fernandes, da Costa Pereira, Jarson Pedro, Gonzalez, M. Cristina, Prado, Carla M., Fayh, Ana Paula Trussardi
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Body Composition; Body fat; Cohort Studies; Colorectal cancer; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Comorbidity; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Musculoskeletal system; Nursing; Nursing Research; Oncology; Pain Medicine; Rehabilitation Medicine; Risk Factors; Tomography, X-Ray Computed - methods
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-024-08730-w

Objective To examine the relationship between the age-adjusted Charlson comorbidity index (A-CCI) with body composition and overall survival in patients newly diagnosed with colorectal cancer (CRC). Research methods and procedures In this cohort study, patients (≥ 18 years old) with CRC were followed for 36 months. Computed tomography images of the third lumbar were analyzed to determine body composition, including skeletal muscle area (SMA), skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Phenotypes based on comorbidity burden assessed by A-CCI and body composition parameters were established. Results A total of 436 participants were included, 50% male, with a mean age of 61 ± 13.2 years. Approximately half of the patients (50.4%) had no comorbidity, and the A-CCI median score was 4 (interquartile range: 3–6). A higher A-CCI score was a risk factor for 36-month mortality (HR = 3.59, 95% CI = 2.17–5.95). Low SMA and low SMD were associated with a higher A-CCI. All abnormal phenotypes (high A-CCI and low SMA; high A-CCI and low SMD; high A-CCI and high VAT) were independently associated with higher 36-month mortality hazard ( adjusted HR 5.12, 95% CI 2.73–9.57; adjusted HR 4.58, 95% CI 2.37–8.85; and adjusted HR 2.36, 95% CI 1.07–5.22, respectively). Conclusion The coexistence of comorbidity burden and abnormal body composition phenotypes, such as alterations in muscle or fat compartments, may pose an additional risk of mortality in patients newly diagnosed with CRC. Early assessment and management of these phenotypes could be crucial in optimizing outcomes in such patients.