Evidence map›Paper›PMID 39711205›Full record

ArticleJournal of cachexia, sarcopenia and muscle2025

CT-Based Body Composition and Frailty as Predictors of Survival Among Older Adults With Gastrointestinal Malignancies.

Smith Giri, Christian Harmon, Daniel Hess, Elizabeth M Cespedes Feliciano, Ijeamaka Anyene Fumagalli, Bette Caan, Leon Lenchik, Karteek Popuri, Vincent Chow, Mirza Faisal Beg and 2 more

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In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Smith GiriInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID 0000-0002-1827-5032
Christian HarmonInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Daniel HessDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Elizabeth M Cespedes FelicianoDivision of Research, Kaiser Permanente, Northern California, Oakland, California, USA.
Ijeamaka Anyene FumagalliDivision of Research, Kaiser Permanente, Northern California, Oakland, California, USA.
Bette CaanDivision of Research, Kaiser Permanente, Northern California, Oakland, California, USA.
Leon LenchikDepartment of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Karteek PopuriDepartment of Computer Science, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
Vincent ChowSchool of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada.
Mirza Faisal BegSchool of Engineering Science, Simon Fraser University, Burnaby, British Columbia, Canada.
Smita BhatiaInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Grant R WilliamsInstitute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Funding

Myopenia and Mechanisms of Chemotherapy Toxicity in Older Adults with Colorectal Cancer: The M&M StudyK08CA234225 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI WILLIAMS, GRANT R · 2018 to 2022
$1.0M
National Cancer Institute of the National Institutes of Health K08CA234225NCI NIH HHS K08 CA234225Walter B. Frommeyer Fellowship in Investigative Medicine at the University of Alabama at Birmingham
6 · The paper itself

Abstract

backgroundOlder adults with cancer are at an increased risk of treatment related toxicities and early death. Routinely collected clinico-demographic characteristics inadequately explain this increased risk limiting accurate prognostication. Prior studies have suggested that altered body composition and frailty are independently associated with worse survival among older adults with cancer; however, their combined influence remains unclear.

methodsWe used data from a single-institution prospective cohort study of older adults (≥ 60 years) who underwent geriatric assessment (GA) at the time of initial consultation with a medical oncologist from September 2017 to December 2020 and available baseline abdominal computed tomography within 60 days of GA. Using multi-slice CT images from T12 to L5 level, we assessed volumetric measures of skeletal muscle (SMV), visceral adipose tissue (VATV), subcutaneous adipose tissue (SATV) and averaged skeletal muscle density (SMD), computing sex-specific z for each measure. Frailty was measured using a 44-item frailty index using the deficit accumulation approach. Primary outcome of interest was overall survival (OS) defined as time from GA to death or last follow up. We used multivariable Cox regression model to study the independent association between the above four body composition measurements and OS adjusted for baseline confounders and frailty.

resultsWe included 459 patients with a mean age of 69.7 ± 7.5 years, 60% males and 77% non-Hispanic Whites. Most had colorectal (27%) or pancreatic cancer (20%) and 48% had stage IV disease. Over a median follow up of 39.4 months, 209 patients (46%) died. In multivariable Cox regression models adjusted for age, sex, race, cancer type, cancer stage and frailty, skeletal muscle volume (HR 0.74; 95% CI 0.58-0.96; p = 0.02, per 1 SD increment) was independently associated with OS. The addition of body composition variables to baseline clinico-demographic variables and frailty led to a slightly improved model discrimination.

conclusionsSMV is independently associated with OS among older adults with newly diagnosed gastrointestinal cancers. Capturing body composition measurements in oncology practice may provide additional prognostic information for older adults with cancer above and beyond what is captured in routine clinical assessment including frailty.

Indexed as

Body CompositionFrailtyGastrointestinal NeoplasmsTomography, X-Ray ComputedAgedAged, 80 and overFemaleGeriatric AssessmentHumansMaleMiddle AgedPrognosisProspective Studiesagingfrailtygeriatric oncologymyosteatosissarcopenia

Identifiers

PMID39711205
PMCPMC11744297

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.