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17-03-2017 | Uitgave 7/2017 Open Access

Quality of Life Research 7/2017

Associations of adipose and muscle tissue parameters at colorectal cancer diagnosis with long-term health-related quality of life

Quality of Life Research > Uitgave 7/2017
Eline H. van Roekel, Martijn J. L. Bours, Malou E. M. te Molder, José J. L. Breedveld-Peters, Steven W. M. Olde Damink, Leo J. Schouten, Silvia Sanduleanu, Geerard L. Beets, Matty P. Weijenberg
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The online version of this article (doi:10.​1007/​s11136-017-1539-z) contains supplementary material, which is available to authorized users.



Increased visceral adiposity (visceral obesity) and muscle wasting (sarcopenia) at colorectal cancer (CRC) diagnosis, quantified by computed tomography (CT) image analysis, have been unfavorably associated with short-term clinical outcomes and survival, but associations with long-term health-related quality of life (HRQoL) have not been investigated. We studied associations of visceral adiposity, muscle fat infiltration, muscle mass, and sarcopenia at CRC diagnosis with HRQoL 2–10 years post-diagnosis.


A cross-sectional study was conducted in 104 stage I‒III CRC survivors, diagnosed at Maastricht University Medical Center+, the Netherlands (2002–2010). Diagnostic CT images at the level of the third lumbar vertebra were analyzed to retrospectively determine visceral adipose tissue area (cm2); intermuscular adipose tissue area (cm2) and mean muscle attenuation (Hounsfield units) as measures of muscle fat infiltration; and skeletal muscle index (SMI, cm2/m2) as measure of muscle mass and for determining sarcopenia.


Participants showed a large variation in body composition parameters at CRC diagnosis with a mean visceral adipose tissue area of 136.1 cm2 (standard deviation: 93.4) and SMI of 47.8 cm2/m2 (7.2); 47% was classified as being viscerally obese, and 32% as sarcopenic. In multivariable linear regression models, associations of the body composition parameters with long-term global quality of life, physical, role and social functioning, disability, fatigue, and distress were not significant, and observed mean differences were below predefined minimal important differences.


Although visceral obesity and sarcopenia are relatively common at CRC diagnosis, we found no significant associations of these parameters with long-term HRQoL in stage I–III CRC survivors.

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