Evidence map›Paper›PMID 31094083›Full record

ArticleJournal of cachexia, sarcopenia and muscle2019

Skeletal muscle mass loss and dose-limiting toxicities in metastatic colorectal cancer patients.

Sophie Kurk, Petra Peeters, Rebecca Stellato, B Dorresteijn, Pim de Jong, Marion Jourdan, Geert-Jan Creemers, Frans Erdkamp, Felix de Jongh, Peter Kint and 7 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cachexia, sarcopenia and muscle, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05899205 (Patient Recorded Indexing Measurements), which is not on this map. Cited by 67 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 2 pooled it
7.4field-weighted citation impact, top 2% of its field
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.

NCT05899205 recruitingnot on this mapstarted 2021, after this paper: background citation

Patient Recorded Indexing Measurements

TypeobservationalSponsorAcademisch Ziekenhuis MaastrichtRan2021 to 2027Enrolled300ConditionsCachexia, Cancer, Weight, Body
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 2 syntheses or guidelines pooled it, 104 citations in OpenAlex.

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  8. Long-chain Polyunsaturated Fatty Acids MitigatebioRxiv : the preprint server for biology · 2026
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7 more citing papers are in PubMed but not listed here.

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

17 authors at 10 institutions in 1 country.

Sophie KurkDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0001-8948-5937
Petra PeetersDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Rebecca StellatoDepartment of Statistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
B DorresteijnDanone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands.
Pim de JongDepartment of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Marion JourdanDanone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands.
Geert-Jan CreemersDepartment of Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands.
Frans ErdkampDepartment of Medical Oncology, Zuyderland Hospital, Sittard-Geleen, The Netherlands.
Felix de JonghDepartment of Internal Medicine and Medical Oncology, Ikazia Hospital, Rotterdam, The Netherlands.
Peter KintDepartment of Radiology, Amphia Hospital, Breda, The Netherlands.
Lieke SimkensDepartment of Medical Oncology, Maxima Medical Center, Eindhoven, The Netherlands.
Bea TanisDepartment of Medical Oncology, Groenehart Hospital, Gouda, The Netherlands.
Manuel Tjin-A-TonDepartment of Medical Oncology, Rivierenland Hospital, Tiel, The Netherlands.
Ankie Van Der VeldenDepartment of Medical Oncology, Tergooi Hospital, Hilversum, The Netherlands.
Cornelis PuntDepartment of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Miriam KoopmanDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Anne MayDepartment of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Utrecht University · NLNutricia Research (Netherlands) · NLRadboud University Nijmegen · NLAmphia Ziekenhuis · NLAmsterdam UMC Location University of Amsterdam · NLGroene Hart Ziekenhuis · NLIkazia Ziekenhuis · NLTergooi · NLZiekenhuis Rivierenland · NLZuyderland Medisch Centrum · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIncreasing evidence suggests that severe skeletal muscle index (SMI) loss (sarcopenia) is associated with poor overall survival in metastatic colorectal cancer patients, but its mechanisms are unknown. We recently found, using data of the randomized phase 3 CAIRO3 study, that SMI loss was related with shorter time to disease progression and overall survival during first-line maintenance treatment with capecitabine + bevacizumab (CAP-B) or observation and during more intensive capecitabine + oxaliplatin + bevacizumab (CAPOX-B) reintroduction treatment. As a potential risk factor for reduced survival, we explored whether sarcopenia and SMI loss were associated with dose-limiting toxicities (DLTs) during CAP-B and CAPOX-B.

methodsSarcopenia status and SMI loss were assessed by using consecutive computed tomography scans. DLTs were defined as any dose delay/reduction/discontinuation of systemic treatment because of reported CTCAE (version 3.0) toxicities at the start or during treatment. Poisson regression models were used to study whether sarcopenia and body mass index (BMI) at the start of treatment and SMI and BMI loss during treatment were associated with DLTs.

resultsOne hundred eighty-two patients (mean age 63.0 ± 8.8 years, 37% female) received CAP-B, and 232 patients (mean age 63.0 ± 9.0 years, 34% female) received CAPOX-B. At the start of CAP-B and CAPOX-B, 54% and 46% of patients were sarcopenic, respectively. Mean BMI was lower in sarcopenic patients, although patients were on average still overweight (sarcopenic vs. non-sarcopenic at the start of CAP-B 25.0 ± 3.9 vs. 26.7 ± 4.1 and CAPOX-B 25.8 ± 3.8 vs. 27.1 ± 3.8 kg/m

conclusionsIn this large longitudinal study in metastatic colorectal cancer patients during palliative systemic treatment, sarcopenia and/or muscle loss was associated with an increased risk of DLTs. BMI was not associated with DLTs and could not detect sarcopenia or SMI loss. Prospective (randomized) studies should reveal whether normalizing chemotherapeutic doses to muscle mass or muscle mass preservation (by exercise and nutritional interventions) increases chemotherapeutic tolerance and improves survival.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsColorectal NeoplasmsDose-Response Relationship, DrugFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasm MetastasisSarcopeniaBody compositionChemotherapyDose-limiting toxicityMetastatic colorectal cancerSarcopeniaSkeletal muscle mass

Identifiers

PMID31094083
PMCPMC6711417
OpenAlexW2945877501

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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 OpenQuestion graph.