The prognostic value of TNM stage and L3-skeletal muscle mass index combined score in elderly patients with colorectal cancer
10.3760/cma.j.issn.0254-9026.2025.03.014
- VernacularTitle:TNM分期与第三腰椎骨骼肌指数联合评分对老年结直肠癌患者预后影响的研究
- Author:
Wenbin LI
1
;
Wanling CHEN
;
Qinfen LAN
;
Wei ZHONG
;
Zhipeng QUE
;
Dongbo XU
Author Information
1. 福建医科大学附属龙岩第一医院临床营养科，龙岩 364000
- Publication Type:Journal Article
- Keywords:
Neoplasm staging;
Colorectal neoplasms;
Predictive value
- From:
Chinese Journal of Geriatrics
2025;44(3):324-329
- CountryChina
- Language:Chinese
-
Abstract:
Objective:We study the prognostic value of TNM stage and L3-skeletal muscle mass index in overall survival(OS)in elderly patients with colorectal cancer after surgery.Furthermore, investigate the prognostic value of combined scoring system(TNM-SMI score)in patients with colorectal cancer.Methods:From January 1, 2018 to January 31, 2019, the clinical data of elderly patients who were diagnosed with colorectal cancer for the first time in Longyan First Hospital, Fujian Medical University were retrospectively analyzed.The baseline data were compared in patients with different TNM stage and L3SMI.The relevant factors that might affect the prognosis of the patients were analyzed to determine the independent risk factors in cox regression analyses.Survival curves were plotted by using the Kaplan-Meier method, and Log-rank test was used to compare Overall Survival.Predictive efficacy was compared by plotting (ROC)curve and calculating the area under the curve(AUC).Results:A total of 128 eligible patients aged 65-88(73.96±6.20)years were enrolled.Among them, 82 were male.Univariate and multifactorial cox regression analyses showed that TNM stage( HR=3.944, 95% CI: 1.519-10.237, P<0.05)and L3SMI( HR=3.194, 95% CI: 1.222-8.349, P<0.05)were the independent risk factors for OS in elderly colorectal cancer patients; Survival curves plotted by Kaplan-Meier method showed that the 5-year survival rate(OS rate)of patients in TNM(Ⅲ and Ⅳ)group was lower than in TNM(Ⅰ and Ⅱ)group(58.8% vs.88.9%, P<0.001), and the 5-year survival rate(OS rate)of patients in low L3SMI group was lower than in high L3SMI group(51.0% vs.88.3%, P<0.001); Elderly colorectal patients were risk stratified by TNM-SMI score, the patients with higher score had worse 5-year OS rate; The AUC of L3SMI, TNM stage, and TNM-SMI score are 0.729, 0.695, and 0.800. Conclusions:The TNM stage and L3SMI are independent risk factors of OS after colorectal cancer surgery; TNM-SMI score, which combines TNM stage and L3SMI, can predict prognosis more efficiency compare to single-factor.The higher TNM-SMI score had the worse prognosis; TNM stage in combination with L3SMI improves the efficiency prediction of OS after colorectal cancer surgery.
