The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer

Ross D Dolan; Kathryn Pennel; Joshua Thompson; Molly McKenzie; Peter Alexander; Colin Richards; Douglas Black; Tanvir Abbass; Noori Maka; Josh McGovern; Antonia Roseweir; Stephen T McSorley; Paul G Horgan; Campbell Roxburgh; Donald C McMillan; Joanne Edwards

doi:10.1038/s44276-024-00119-w

The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer

Ross D Dolan (Lead / Corresponding author)
, Kathryn Pennel
, Joshua Thompson
, Molly McKenzie
, Peter Alexander
, Colin Richards
, Douglas Black
, Tanvir Abbass
, Noori Maka
, Josh McGovern
, Antonia Roseweir
, Stephen T McSorley
, Paul G Horgan
, Campbell Roxburgh
, Donald C McMillan
, Joanne Edwards

Cancer Research

Research output: Contribution to journal › Article › peer-review

5 Downloads (Pure)

Abstract

BACKGROUND

In cancer cachexia the relationship between the tumour, its environment and the systemic inflammatory response is not clear. This study aims to examine this relationship in greater detail.

METHODS

Host characteristics included the presence of a Systemic Inflammatory Response (SIR) as measured by Systemic Inflammatory Grade (SIG), sarcopenia (SMI) and myosteatosis (SMD) were measured. Categorical variables were analysed using χ 2 test for linear-by-linear association, or χ 2 test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression.

RESULTS

A total of 473 patients were included. Of these, 70.4% were over 65 years of age, 54.8% were male and 49.8% had an ASA grade of 1 or 2. Pathological examination showed that the majority of patients had a T3 (53.7%) or a T4 (34.0%) cancer and 73.0% had evidence of necrosis. A SIG score of 0 or 1 was present in 57.7% of patients. Tumour necrosis was associated with age (p < 0.01), tumour location (p < 0.01), T-stage (p < 0.001), margin involvement (p < 0.05), SIG (p < 0.001), SMI (p < 0.01), SMD (p < 0.05) and 5-year survival (p < 0.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95% CI 1.13-1.86 p < 0.01), ASA grade (HR: 1.50 95% CI 1.15-1.95 p < 0.01) and SIG (HR: 1.28 95% CI 1.11-1.48 p < 0.001) remained independently associated with survival.

CONCLUSION

These results suggest that tumour necrosis and the subsequent SIR could result in profound changes in body composition and survival. Further pre-clinical and clinical work is required to prove causation.

Original language	English
Article number	7
Number of pages	10
Journal	BJC Reports
Volume	3
DOIs	https://doi.org/10.1038/s44276-024-00119-w
Publication status	Published - 5 Feb 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1038/s44276-024-00119-wLicence: CC BY

Final Published VersionFinal published version, 765 KBLicence: CC BY

The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer Does tumour necrosis drive cachexia?
Dolan, R. D., Pennel, K., Thompson, J., McKenzie, M., Alexander, P., Richards, C., Black, D., Abbass, T., Maka, N., McGovern, J., Roseweir, A., McSorley, S. T., Horgan, P. G., Roxburgh, C., McMillan, D. C. & Edwards, J., 26 Apr 2024, Research Square, 29 p.
Research output: Working paper/Preprint › Preprint

File
1 Downloads (Pure)

Cite this

Dolan, R. D., Pennel, K., Thompson, J., McKenzie, M., Alexander, P., Richards, C., Black, D., Abbass, T., Maka, N., McGovern, J., Roseweir, A., McSorley, S. T., Horgan, P. G., Roxburgh, C., McMillan, D. C., & Edwards, J. (2025). The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3, Article 7. https://doi.org/10.1038/s44276-024-00119-w

@article{373b60ceb12441e490c4fe2095b86801,

title = "The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer",

abstract = "BACKGROUND In cancer cachexia the relationship between the tumour, its environment and the systemic inflammatory response is not clear. This study aims to examine this relationship in greater detail.METHODS Host characteristics included the presence of a Systemic Inflammatory Response (SIR) as measured by Systemic Inflammatory Grade (SIG), sarcopenia (SMI) and myosteatosis (SMD) were measured. Categorical variables were analysed using χ 2 test for linear-by-linear association, or χ 2 test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression. RESULTS A total of 473 patients were included. Of these, 70.4\% were over 65 years of age, 54.8\% were male and 49.8\% had an ASA grade of 1 or 2. Pathological examination showed that the majority of patients had a T3 (53.7\%) or a T4 (34.0\%) cancer and 73.0\% had evidence of necrosis. A SIG score of 0 or 1 was present in 57.7\% of patients. Tumour necrosis was associated with age (p < 0.01), tumour location (p < 0.01), T-stage (p < 0.001), margin involvement (p < 0.05), SIG (p < 0.001), SMI (p < 0.01), SMD (p < 0.05) and 5-year survival (p < 0.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95\% CI 1.13-1.86 p < 0.01), ASA grade (HR: 1.50 95\% CI 1.15-1.95 p < 0.01) and SIG (HR: 1.28 95\% CI 1.11-1.48 p < 0.001) remained independently associated with survival.CONCLUSION These results suggest that tumour necrosis and the subsequent SIR could result in profound changes in body composition and survival. Further pre-clinical and clinical work is required to prove causation.",

author = "Dolan, \{Ross D\} and Kathryn Pennel and Joshua Thompson and Molly McKenzie and Peter Alexander and Colin Richards and Douglas Black and Tanvir Abbass and Noori Maka and Josh McGovern and Antonia Roseweir and McSorley, \{Stephen T\} and Horgan, \{Paul G\} and Campbell Roxburgh and McMillan, \{Donald C\} and Joanne Edwards",

note = "{\textcopyright} 2025. The Author(s).",

year = "2025",

month = feb,

day = "5",

doi = "10.1038/s44276-024-00119-w",

language = "English",

volume = "3",

journal = "BJC Reports",

issn = "2731-9377",

publisher = "Springer Nature [academic journals on nature.com]",

}

Dolan, RD, Pennel, K, Thompson, J, McKenzie, M, Alexander, P, Richards, C, Black, D, Abbass, T, Maka, N, McGovern, J, Roseweir, A, McSorley, ST, Horgan, PG, Roxburgh, C, McMillan, DC & Edwards, J 2025, 'The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer', BJC Reports, vol. 3, 7. https://doi.org/10.1038/s44276-024-00119-w

TY - JOUR

T1 - The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer

AU - Dolan, Ross D

AU - Pennel, Kathryn

AU - Thompson, Joshua

AU - McKenzie, Molly

AU - Alexander, Peter

AU - Richards, Colin

AU - Black, Douglas

AU - Abbass, Tanvir

AU - Maka, Noori

AU - McGovern, Josh

AU - Roseweir, Antonia

AU - McSorley, Stephen T

AU - Horgan, Paul G

AU - Roxburgh, Campbell

AU - McMillan, Donald C

AU - Edwards, Joanne

PY - 2025/2/5

Y1 - 2025/2/5

N2 - BACKGROUND In cancer cachexia the relationship between the tumour, its environment and the systemic inflammatory response is not clear. This study aims to examine this relationship in greater detail.METHODS Host characteristics included the presence of a Systemic Inflammatory Response (SIR) as measured by Systemic Inflammatory Grade (SIG), sarcopenia (SMI) and myosteatosis (SMD) were measured. Categorical variables were analysed using χ 2 test for linear-by-linear association, or χ 2 test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression. RESULTS A total of 473 patients were included. Of these, 70.4% were over 65 years of age, 54.8% were male and 49.8% had an ASA grade of 1 or 2. Pathological examination showed that the majority of patients had a T3 (53.7%) or a T4 (34.0%) cancer and 73.0% had evidence of necrosis. A SIG score of 0 or 1 was present in 57.7% of patients. Tumour necrosis was associated with age (p < 0.01), tumour location (p < 0.01), T-stage (p < 0.001), margin involvement (p < 0.05), SIG (p < 0.001), SMI (p < 0.01), SMD (p < 0.05) and 5-year survival (p < 0.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95% CI 1.13-1.86 p < 0.01), ASA grade (HR: 1.50 95% CI 1.15-1.95 p < 0.01) and SIG (HR: 1.28 95% CI 1.11-1.48 p < 0.001) remained independently associated with survival.CONCLUSION These results suggest that tumour necrosis and the subsequent SIR could result in profound changes in body composition and survival. Further pre-clinical and clinical work is required to prove causation.

AB - BACKGROUND In cancer cachexia the relationship between the tumour, its environment and the systemic inflammatory response is not clear. This study aims to examine this relationship in greater detail.METHODS Host characteristics included the presence of a Systemic Inflammatory Response (SIR) as measured by Systemic Inflammatory Grade (SIG), sarcopenia (SMI) and myosteatosis (SMD) were measured. Categorical variables were analysed using χ 2 test for linear-by-linear association, or χ 2 test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression. RESULTS A total of 473 patients were included. Of these, 70.4% were over 65 years of age, 54.8% were male and 49.8% had an ASA grade of 1 or 2. Pathological examination showed that the majority of patients had a T3 (53.7%) or a T4 (34.0%) cancer and 73.0% had evidence of necrosis. A SIG score of 0 or 1 was present in 57.7% of patients. Tumour necrosis was associated with age (p < 0.01), tumour location (p < 0.01), T-stage (p < 0.001), margin involvement (p < 0.05), SIG (p < 0.001), SMI (p < 0.01), SMD (p < 0.05) and 5-year survival (p < 0.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95% CI 1.13-1.86 p < 0.01), ASA grade (HR: 1.50 95% CI 1.15-1.95 p < 0.01) and SIG (HR: 1.28 95% CI 1.11-1.48 p < 0.001) remained independently associated with survival.CONCLUSION These results suggest that tumour necrosis and the subsequent SIR could result in profound changes in body composition and survival. Further pre-clinical and clinical work is required to prove causation.

U2 - 10.1038/s44276-024-00119-w

DO - 10.1038/s44276-024-00119-w

M3 - Article

C2 - 39910331

SN - 2731-9377

VL - 3

JO - BJC Reports

JF - BJC Reports

M1 - 7

ER -

The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer

Abstract

UN SDGs

Access to Document

Fingerprint

Research output

The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer Does tumour necrosis drive cachexia?

Cite this