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Purpose <p>Tumor progression is influenced by both tumor-intrinsic and host-related factors. Among the latter, cachexia—a multifactorial syndrome involving progressive skeletal muscle loss—has garnered increasing attention for its prognostic relevance. However, objective assessment of cachexia remains difficult. The cachexia index (CXI) has emerged as a novel biomarker for its evaluation. This study aimed to assess the relationship between cachexia and long-term prognosis following curative surgery for colorectal cancer (CRC) using a modified index.</p> Methods <p>We retrospectively analyzed 298 patients who underwent curative colorectal cancer resection at Osaka City University Hospital between January 2017 and December 2019. A modified version of CXI, termed the P-CXI, was calculated using the psoas muscle index (cm<sup>2</sup>/m<sup>2</sup>), serum albumin (g/dL), and neutrophil-to-lymphocyte ratio (NLR):</p> <p>P-CXI = (psoas muscle index × albumin) / NLR.</p> <p>Patients were stratified into high and low P-CXI groups. Prognostic value for relapse-free survival (RFS) and overall survival (OS) was evaluated using univariate and multivariate Cox regression analyses.</p> Results <p>The low P-CXI group (<i>n</i> = 170) had significantly shorter RFS and OS compared to that of the high P-CXI group (<i>p</i> = 0.001 and <i>p</i> &lt; 0.001, respectively). Multivariate analysis identified low P-CXI as an independent poor prognostic factor for RFS (HR: 2.627, 95% CI 1.363–5.063, <i>p</i> = 0.004) and OS (HR: 5.370, 95% CI 1.806–15.96, <i>p</i> = 0.002), along with older age, T4 tumors, and elevated CA 19–9.</p> Conclusion <p>Cachexia, as quantified by P-CXI, was significantly associated with worse long-term outcomes after curative CRC resection. P-CXI may serve as a simple and objective prognostic marker.</p>

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Prognostic Impact of Cachexia in Patients Undergoing Radical Resection for Colorectal Cancer: A Retrospective Study

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Hideki Tanda,
  • Masatsune Shibutani,
  • Yuki Seki,
  • Tsuyoshi Nishiyama,
  • Hiroaki Kasashima,
  • Tatsunari Fukuoka,
  • Kiyoshi Maeda

摘要

Purpose

Tumor progression is influenced by both tumor-intrinsic and host-related factors. Among the latter, cachexia—a multifactorial syndrome involving progressive skeletal muscle loss—has garnered increasing attention for its prognostic relevance. However, objective assessment of cachexia remains difficult. The cachexia index (CXI) has emerged as a novel biomarker for its evaluation. This study aimed to assess the relationship between cachexia and long-term prognosis following curative surgery for colorectal cancer (CRC) using a modified index.

Methods

We retrospectively analyzed 298 patients who underwent curative colorectal cancer resection at Osaka City University Hospital between January 2017 and December 2019. A modified version of CXI, termed the P-CXI, was calculated using the psoas muscle index (cm2/m2), serum albumin (g/dL), and neutrophil-to-lymphocyte ratio (NLR):

P-CXI = (psoas muscle index × albumin) / NLR.

Patients were stratified into high and low P-CXI groups. Prognostic value for relapse-free survival (RFS) and overall survival (OS) was evaluated using univariate and multivariate Cox regression analyses.

Results

The low P-CXI group (n = 170) had significantly shorter RFS and OS compared to that of the high P-CXI group (p = 0.001 and p < 0.001, respectively). Multivariate analysis identified low P-CXI as an independent poor prognostic factor for RFS (HR: 2.627, 95% CI 1.363–5.063, p = 0.004) and OS (HR: 5.370, 95% CI 1.806–15.96, p = 0.002), along with older age, T4 tumors, and elevated CA 19–9.

Conclusion

Cachexia, as quantified by P-CXI, was significantly associated with worse long-term outcomes after curative CRC resection. P-CXI may serve as a simple and objective prognostic marker.