International Journal of Clinical Oncology

, Volume 24, Issue 10, pp 1204–1213 | Cite as

Skeletal muscle loss during systemic chemotherapy for colorectal cancer indicates treatment response: a pooled analysis of a multicenter clinical trial (KSCC 1605-A)

  • Shun Sasaki
  • Eiji OkiEmail author
  • Hiroshi Saeki
  • Takayuki Shimose
  • Sanae Sakamoto
  • Qingjiang Hu
  • Kensuke Kudo
  • Yasuo Tsuda
  • Yuichiro Nakashima
  • Koji Ando
  • Yoshito Akagi
  • Yoshihiro Kakeji
  • Hideo Baba
  • Yoshihiko Maehara



Sarcopenia or degenerative loss of skeletal muscle mass is related to poor prognosis in patients with cancer. This study aimed to clarify the clinical significance of skeletal muscle loss (SML) during chemotherapy for metastatic colorectal cancer (mCRC).


A total of 249 patients who were secondarily registered in a pooled database of mCRC patients with the first-line systemic chemotherapy and prospectively enrolled in six clinical trials of Kyushu Study Group of Clinical Cancer were included in this study. Skeletal muscle area was calculated from computed tomography images before and 3 and 6 months after treatment. Baseline sarcopenia and SML (cut-off value = 9%) were evaluated.


Baseline sarcopenia was observed in 135 of 219 patients who were evaluated before treatment. They tended to be male; older; and have lower body mass index, lower visceral and subcutaneous fat contents, and a lower waist circumference (P < 0.01); however, baseline sarcopenia was not associated with prognosis. SML at 3 months was associated with an incidence of adverse events (P = 0.01), poor objective response rate (ORR) (P < 0.01), and poor progression-free survival (PFS) (P = 0.03), and it was an independent predictive factor for poor ORR (P < 0.01) and PFS (P = 0.04).


SML at 3 months after systemic chemotherapy for mCRC was associated with poor treatment response. Thus, clarifying the importance of SML prevention guarantees a more effective chemotherapy.


Cachexia Chemotherapy response Metastatic colorectal cancer Sarcopenia Skeletal muscle loss 



This study received no financial or material support. The authors thank the following institutions and investigators who participated in this study: Baba H (Kumamoto University Hospital), Kakeji Y (Kobe University Hospital), Akagi Y (Kurume University Hospital), Ogata Y (Kurume University Hospital), Eguchi S (Nagasaki University Hospital), Nishimaki T (Ryukyu University Hospital), and Natsugoe S (Kagoshima University Hospital). We also thank Sakamoto S and the staff at the Clinical Research Support Center Kyushu (CReS Kyushu) for their excellent data collection and management and secretarial assistance. We thank Shimose T for the statistical analysis. This work was supported by CReS Kyushu with no funding. We would like to thank Editage ( for English language editing.

Compliance with ethical standards

Conflict of interest

We declare that we have no conflict of interest.

Supplementary material

10147_2019_1460_MOESM1_ESM.docx (39 kb)
Supplementary file1 (DOCX 38 kb)


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Shun Sasaki
    • 1
  • Eiji Oki
    • 1
    Email author
  • Hiroshi Saeki
    • 1
  • Takayuki Shimose
    • 2
  • Sanae Sakamoto
    • 2
  • Qingjiang Hu
    • 1
  • Kensuke Kudo
    • 1
    • 3
  • Yasuo Tsuda
    • 1
  • Yuichiro Nakashima
    • 1
  • Koji Ando
    • 1
  • Yoshito Akagi
    • 4
  • Yoshihiro Kakeji
    • 5
  • Hideo Baba
    • 6
  • Yoshihiko Maehara
    • 1
    • 7
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Kyushu Study Group of Clinical CancerFukuokaJapan
  3. 3.Endoscopy and Endoscopic SurgeryFukuoka Dental CollegeFukuokaJapan
  4. 4.Department of SurgeryKurume University School of MedicineKurumeJapan
  5. 5.Division of Gastrointestinal Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan
  6. 6.Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  7. 7.Department of SurgeryKyushu Central HospitalFukuokaJapan

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