This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Longitudinal Changes in Nutritional, Inflammatory, and CT-Derived Body Composition Markers During Adjuvant Chemotherapy for Stage II/III Colorectal Cancer
by
, , , ,
Makoto Hasegawa
1,2
,
Tomoyuki Momma
1,*,
Shizuka Kimura
3,
Hitomi Ichinose
3,
Hiroki Yago
1,
Takahiro Sato
1,
Misato Ito
1,
Takuro Matsumoto
1,
Daisuke Ujiie
1,
Shun Chida
1,
Hirokazu Okayama
1,
Motonobu Saito
1,
Wataru Sakamoto
1,4 and
Koji Kono
1 1
Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
2
Department of Gastroenterology, Kita Fukushima Medical Center, Date 960-0502, Japan
3
Department of Nutrition, Fukushima Medical University Hospital, Fukushima 960-1295, Japan
4
Department of Gastroenterological Surgery, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu 969-3492, Japan
*
Author to whom correspondence should be addressed.
Cancers 2026, 18(17), 2886; https://doi.org/10.3390/cancers18172886
Submission received: 11 August 2026
/
Revised: 3 September 2026
/
Accepted: 4 September 2026
/
Published: 6 September 2026
(This article belongs to the Section Clinical Research in Cancer)
Simple Summary
Patients with colorectal cancer may experience changes in nutritional status, inflammation, and body composition throughout the perioperative period and during subsequent adjuvant chemotherapy, but these changes are not well described. In this single-center retrospective study of 142 patients with Stage II/III colorectal cancer, several nutritional markers improved and inflammatory markers decreased between the preoperative assessment and 6 months after adjuvant chemotherapy initiation. Among patients receiving oxaliplatin-based doublet therapy, poorer preoperative nutritional and inflammatory status was associated with treatment discontinuation. In the monotherapy group, older age was the only factor significantly associated with discontinuation. In addition, lower preoperative muscle quality measured by computed tomography was associated with poorer overall survival, whereas muscle quantity was not. These findings suggest that nutritional, inflammatory, and muscle quality assessments may help identify patients who require closer supportive care.
Abstract
Background/Objectives: Evidence on longitudinal changes in nutrition, inflammation, and body composition during adjuvant chemotherapy for Stage II/III colorectal cancer (CRC) remains limited. We therefore evaluated these changes and explored preoperative factors associated with treatment discontinuation and prognosis. Methods: This single-center retrospective study included patients with Stage II/III CRC who underwent curative surgery and adjuvant chemotherapy. Body mass index (BMI), computed tomography (CT)-derived psoas muscle index (PMI), psoas muscle density (PMD), modified intramuscular adipose tissue content (mIMAC), Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), hemoglobin–albumin–lymphocyte–platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were assessed preoperatively and 6 months after chemotherapy initiation. Analyses were stratified into oxaliplatin-based doublet therapy (CAPOX/FOLFOX) and fluoropyrimidine monotherapy. Results: Among 142 patients, GNRI, PNI, and HALP score increased, whereas BMI, NLR, and PLR decreased from preoperative assessment to follow-up. Adjuvant therapy was discontinued in 45 patients (31.7%). In the doublet therapy group, discontinuation was associated with lower preoperative GNRI, PNI, and HALP scores and higher NLR and PLR. In the monotherapy group, only older age was associated with discontinuation. Lower preoperative PMD and mIMAC, but not PMI, were associated with poorer overall survival. No other nutritional or inflammatory markers were associated with overall survival. Conclusions: Several nutritional and inflammatory markers improved from preoperative assessment to follow-up. Preoperative nutritional and inflammatory markers were associated with treatment discontinuation, particularly in the doublet therapy group. CT-derived muscle quality markers were associated with overall survival, suggesting prognostic relevance of muscle quality in this setting.
