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This study aims to examine this relationship in greater detail.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>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 \u03c7<jats:sup>2<\/jats:sup> test for linear-by-linear association, or \u03c7<jats:sup>2<\/jats:sup> test for 2 by 2 tables. Survival analysis was carried out using univariate and multivariate Cox regression.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>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 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), tumour location (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), T-stage (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), margin involvement (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), SIG (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), SMI (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), SMD (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and 5-year survival (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). On multivariate survival analysis in patients with T3 cancers age (HR: 1.45 95% CI 1.13\u20131.86 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), ASA grade (HR: 1.50 95% CI 1.15\u20131.95 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and SIG (HR: 1.28 95% CI 1.11\u20131.48 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) remained independently associated with survival.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s44276-024-00119-w","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T10:56:23Z","timestamp":1738752983000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer"],"prefix":"10.1038","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5272-5906","authenticated-orcid":false,"given":"Ross D.","family":"Dolan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Pennel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"McKenzie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Richards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvir","family":"Abbass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noori","family":"Maka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"McGovern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Roseweir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen T.","family":"McSorley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Horgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Campbell","family":"Roxburgh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald C.","family":"McMillan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"119_CR1","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1017\/s0029665108007131","volume":"67","author":"DC McMillan","year":"2008","unstructured":"McMillan DC. 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