{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:20:21Z","timestamp":1784179221205,"version":"3.55.0"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Province of Utrecht, the Netherlands"},{"name":"Dutch Colorectal Cancer Group"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Skeletal muscle mass (SMM) loss is common in metastatic colorectal cancer (mCRC) patients and associated with poor clinical outcomes, including increased treatment\u2010related toxicities and reduced survival. Muscle loss may contribute to reduced health\u2010related quality of life (HRQoL), including fatigue. Our aim was to study associations between changes in SMM and concomitant changes in patient\u2010reported HRQoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of mCRC patients in the CAIRO3 randomized clinical trial who were\u2014after initial treatment\u2014randomized between maintenance treatment with capecitabine plus bevacizumab (CAP\u2010B) and observation until first disease progression (PD1). Included patients had computed tomography images for SMM quantification, together with HRQoL assessments available at randomization and PD1. Changes in SMM (categorized as &gt;2% loss, stable, and &gt;2% gain) and HRQoL were computed between randomization and PD1. Changes in HRQoL score &gt;10 points were considered clinically relevant. Associations between SMM and HRQoL changes were studied by multiple linear regression models. We also investigated whether associations differed by treatment arm for global health and the 13 other HRQoL subscales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 221 patients included (mean age 63.5\u00a0\u00b1\u00a08.4\u00a0years), 24% lost, 27% remained stable, and 49% gained SMM. At randomization, mean global health status was 73.5\u00a0\u00b1\u00a015.9 in the CAP\u2010B arm and 75.1\u00a0\u00b1\u00a017.5 in the observation arm (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.48). A stable or gain in SMM was significantly associated with a clinically relevant improvement in global health status (9.9 and 14.7 points, respectively), compared with patients who lost SMM. From the subscales that did not show significant differences between the two treatment arms, we found significant and clinically relevant associations for stable or gain in SMM with improved role functioning (12.0 and 17.9, respectively) and with less fatigue (\u221210.0 and \u221215.0, respectively) and pain (\u221216.3 for SMM gain). From the subscales that did show significantly different associations with SMM between the two treatment arms, we only found significant results in the observation arm. Here, associations were found for stable or gain in SMM with clinically relevant improved physical (12.4 for SMM gain), cognitive (10.7 and 9.7, respectively), and social functioning (15.5 and 15.6, respectively) as well as reduced appetite loss (\u221228.5 and \u221230.7, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In mCRC, SMM preservation during CAP\u2010B and observation treatment is associated with significant and clinically relevant improvements in global health status and multiple functional and symptom scales. Studies are warranted to investigate whether interventions targeting SMM lead to improved HRQoL, fewer symptoms, and better functioning.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12562","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T13:44:49Z","timestamp":1582897489000},"page":"919-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["The association between changes in muscle mass and quality of life in patients with metastatic colorectal cancer"],"prefix":"10.1002","volume":"11","author":[{"given":"Jeroen W.G.","family":"Derksen","sequence":"first","affiliation":[{"name":"Department of Medical Oncology University Medical Center Utrecht, Utrecht University  Utrecht The Netherlands"},{"name":"Department of Epidemiology, Julius Center for Health Sciences and Primary Care University Medical Center Utrecht, Utrecht University  GA Utrecht The 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Jourdan","sequence":"additional","affiliation":[{"name":"Danone Nutricia Research Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankie M.T.","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tergooi Hospital  Hilversum The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nieboer","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Wilhemina Hospital  Assen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Martini Hospital  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aafke 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