Cancer Research and Treatment

Original Articles

Breast cancer

Endoxifen Concentration Is Associated with Recurrence-Free Survival in Hormone-Sensitive Breast Cancer Patients: Beomki Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jeong Eon Lee, Soo-Youn Lee; Cancer Res Treat. 2025;57(1):140-149. Published online June 18, 2024; DOI: https://doi.org/10.4143/crt.2023.1285

Abstract PDF PubReader ePub: Purpose
The metabolism of tamoxifen is influenced by various cytochrome p450 enzymes, including CYP2D6 and CYP2C19, leading to variations in the levels of endoxifen, even with the same tamoxifen dose. However, the clinical significance of endoxifen for the prognosis of breast cancer patients remains controversial. This study aimed to elucidate the relevance of endoxifen level to recurrence-free survival censored with tamoxifen discontinuation (RFSt), representing the RFS for tamoxifen itself, of breast cancer patients and determine a suitable cutoff for prognostication.
Materials and Methods
The study included 478 breast cancer patients. Tamoxifen and its metabolites, including endoxifen, were measured using liquid chromatography-tandem mass spectrometry. An optimal cutoff was determined with maximally selected rank statistics. Survival analysis and Cox regression were conducted based on this cutoff.
Results
An endoxifen level of 21.00 ng/mL was the optimal cutoff for prognostication. Survival analysis revealed a statistically significant difference in RFSt between the low endoxifen group (≤ 21.00 ng/mL) and the high endoxifen group (> 21.00 ng/mL) (log-rank test, p=0.032). The 10-year probability of RFSt was 83.2% (95% confidence interval [CI], 77.0 to 89.9) and 88.3% (95% CI, 83.3 to 93.5) in the low and high endoxifen groups, respectively. Multivariable Cox proportional hazards regression indicated endoxifen concentration as a significant factor associated with prognosis.
Conclusion
Endoxifen could serve as a marker for appropriate tamoxifen treatment with a cutoff of 21.00 ng/mL. Based on this cutoff, therapeutic drug monitoring would benefit patients displaying suboptimal endoxifen concentrations.

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Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients: Jin Soo Han, Hyoseon Ryu, In Ja Park, Kyung Won Kim, Yongbin Shin, Sun Ok Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim; Cancer Res Treat. 2020;52(2):563-572. Published online December 3, 2019; DOI: https://doi.org/10.4143/crt.2019.249

Abstract PDF PubReader ePub

Purpose
We evaluated the association of body composition with long-term oncologic outcomes in non-metastatic rectal cancer patients.
Methods
We included 1,384 patients with stage(y)0-III rectal cancer treated at Asan Medical Center between January 2005 and December 2012. Body composition at diagnosis was measured using abdomino-pelvic computed tomography (CT). Sarcopenia, visceral obesity (VO), and sarcopenic obesity (SO) were defined using CT measured parameters such as skeletal muscle index (total abdominal muscle area, TAMA), visceral fat area (VFA), and VFA/TAMA. Inflammatory status was defined as a neutrophil-lymphocyte ratio of ≥3. Obesity was categorized by body mass index (≥ 25 kg/m²).
Results
Among the 1,384 patients, 944 (68.2%) had sarcopenia and 307 (22.2%) had SO. The 5-year overall survival (OS) rate was significantly lower in sarcopenic patients (no sarcopenia vs. sarcopenia; 84% vs. 78%, p=0.003) but the 5-year recurrence-free survival (RFS) rate was not different (77.3% vs. 77.9% p=0.957). Patients with SO showed lower 5-year OS (79.1% vs. 75.5% p=0.02) but no difference in 5-year RFS (p=0.957). Sarcopenia, SO, VO, and obesity were not associated with RFS. However, obesity, SO, age, sex, inflammatory status, and tumor stage were confirmed as independent factors associated with OS on multivariate analysis. In subgroup analysis, association of SO with OS was more prominent in patients with (y)p stage 0-2 and no inflammatory status.
Conclusion
The presence of SO and a low body mass index at diagnosis are negatively associated with OS in non-metastatic rectal cancer patients.

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Tuba Nur Yıldız Kopuz, Hanifi Furkan Yıldız, Sadettin Er, Mehmet Fisunoğlu
Nutrition and Cancer.2025; 77(3): 360. CrossRef
Effect of sarcopenic obesity on treatment results in patients with malignant tumors of the gastrointestinal tract: systematic review
T. S. Boldyreva, V. K. Lyadov
Supportive Therapy in Oncology.2025; 1(3): 26. CrossRef
Radiological Assessment of Sarcopenia and Its Clinical Impact in Patients with Hepatobiliary, Pancreatic, and Gastrointestinal Diseases: A Comprehensive Review
Shameema Farook, Saumya Soni, Arpit Shantagiri, Pankaj Gupta, Anindita Sinha, Mahesh Prakash
Journal of Gastrointestinal and Abdominal Radiology.2024; 07(01): 027. CrossRef
Landscape and research trends of sarcopenic obesity research: A bibliometric analysis
Huiyu Tang, Rongna Lian, Runjie Li, Jiaojiao Jiang, Ming Yang
Heliyon.2024; 10(2): e24696. CrossRef
Predictive role of preoperative sarcopenia for long-term survival in rectal cancer patients: A meta-analysis
Qiutong Su, Jia Shen, Zubing Mei
PLOS ONE.2024; 19(5): e0303494. CrossRef
Sarcopenic obesity in cancer
Mihaela Jurdana, Maja Cemazar
Radiology and Oncology.2024; 58(1): 1. CrossRef
Negative impact of sarcopenia on survival in elderly patients with colorectal cancer receiving surgery: A propensity‑score matched analysis
Takeshi Nishikawa, Tetsuro Taira, Nao Kakizawa, Riki Ohno, Toshiya Nagasaki
Oncology Letters.2024;[Epub] CrossRef
Impact of body composition parameters on radiation therapy compliance in locally advanced rectal cancer: A retrospective observational analysis
Giuditta Chiloiro, Marco Cintoni, Marta Palombaro, Angela Romano, Sara Reina, Gabriele Pulcini, Barbara Corvari, Silvia Di Franco, Elisa Meldolesi, Gabriele Egidi, Futura Grassi, Pauline Raoul, Emanuele Rinninella, Antonio Gasbarrini, Maria Cristina Mele,
Clinical and Translational Radiation Oncology.2024; 47: 100789. CrossRef
Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis
Nerea Becerra‐Tomás, Georgios Markozannes, Margarita Cariolou, Katia Balducci, Rita Vieira, Sonia Kiss, Dagfinn Aune, Darren C. Greenwood, Laure Dossus, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark‐Wahnefried, Melissa M. Hudson, Anne M. Ma
International Journal of Cancer.2024; 155(3): 400. CrossRef
Sarcopenia diagnosis in patients with colorectal cancer: a review of computed tomography-based assessments and emerging ways to enhance practicality
Hye Jung Cho, Jeonghyun Kang
Annals of Surgical Treatment and Research.2024; 106(6): 305. CrossRef
Serum tumor marker and CT body composition scoring system predicts outcomes in colorectal cancer surgical patients
Mingming Song, Zhihao Liu, Feihong Wu, Tong Nie, Yixin Heng, Jiaxin Xu, Ning Huang, Xiaoyu Wu, Yinghao Cao, Gang Hu
European Radiology.2024; 34(12): 7596. CrossRef
Computed tomography-measured body composition can predict long-term outcomes for stage I-III colorectal cancer patients
Han Zhou, Lei Tian, Yiting Wu, Sibin Liu
Frontiers in Oncology.2024;[Epub] CrossRef
Prognostic significance of serum creatinine and sarcopenia for 5-year overall survival in patients with colorectal cancer in Korea: a comparative study
Jiahn Choi, Hye Sun Lee, Jeonghyun Kang
Annals of Clinical Nutrition and Metabolism.2024; 16(2): 66. CrossRef
Age as a modifier of the effects of sarcopenia on survival among colon cancer patients after surgery
Wen‐Li Lin, Li‐Min Wu, Wen‐Tsung Huang, How‐Ran Guo, Jyh‐Jou Chen
Journal of Surgical Oncology.2023; 128(7): 1121. CrossRef
Associations of muscle and adipose tissue parameters with long-term outcomes in middle and low rectal cancer: a retrospective cohort study
Jiyang Liu, Xiongfeng Yu, Xueqing Huang, Qingquan Lai, Jieyun Chen
Cancer Imaging.2023;[Epub] CrossRef
Associations of Total Body Fat Mass and Skeletal Muscle Index with All-Cause and Cancer-Specific Mortality in Cancer Survivors
Livingstone Aduse-Poku, Shama D. Karanth, Meghann Wheeler, Danting Yang, Caretia Washington, Young-Rock Hong, Todd M. Manini, Jesus C. Fabregas, Ting-Yuan David Cheng, Dejana Braithwaite
Cancers.2023; 15(4): 1081. CrossRef
Prognostic effect of sarcopenia in patients undergoing laparoscopic rectal cancer resection
Giuseppe Portale, Matteo Zuin, Ylenia Camilla Spolverato, Patrizia Bartolotta, Dario Gregori, Carlo Rettore, Luca Cancian, Alberto Morabito, Teodoro Sava, Valentino Fiscon
ANZ Journal of Surgery.2023; 93(6): 1631. CrossRef
Nomogram for predicting the overall survival of underweight patients with colorectal cancer: a clinical study
Jun Woo Bong, Younghyun Na, Yeonuk Ju, Chinock Cheong, Sanghee Kang, Sun Il Lee, Byung Wook Min
BMC Gastroenterology.2023;[Epub] CrossRef
Prognostic role of platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte, and lymphocyte-to-monocyte ratio in operated rectal cancer patients: systematic review and meta-analysis
Giuseppe Portale, Patrizia Bartolotta, Danila Azzolina, Dario Gregori, Valentino Fiscon
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
The effects of muscle mass and quality on mortality of patients with acute kidney injury requiring continuous renal replacement therapy
Jiyun Jung, Jangwook Lee, Jeong-Hoon Lim, Yong Chul Kim, Tae Hyun Ban, Woo Yeong Park, Kyeong Min Kim, Kipyo Kim, Sung Woo Lee, Sung Joon Shin, Seung Seok Han, Dong Ki Kim, Yousun Ko, Kyung Won Kim, Hyosang Kim, Jae Yoon Park
Scientific Reports.2023;[Epub] CrossRef
Sarcopenic Obesity Is a Risk Factor for Worse Oncological Long-Term Outcome in Locally Advanced Rectal Cancer Patients: A Retrospective Single-Center Cohort Study
Peter Tschann, Markus P. Weigl, Patrick Clemens, Philipp Szeverinski, Christian Attenberger, Matthias Kowatsch, Tarkan Jäger, Klaus Emmanuel, Thomas Brock, Ingmar Königsrainer
Nutrients.2023; 15(11): 2632. CrossRef
Association between Computed Tomography-Determined Loss of Muscle Mass and Impaired Three-Month Survival in Frail Older Adults with Cancer
Antti Tolonen, Hanna Kerminen, Kaisa Lehtomäki, Heini Huhtala, Maarit Bärlund, Pia Österlund, Otso Arponen
Cancers.2023; 15(13): 3398. CrossRef
Diagnosis and prevalence of sarcopenic obesity in patients with colorectal cancer: A scoping review
Yoko Saino, Fumiya Kawase, Ayano Nagano, Junko Ueshima, Haruko Kobayashi, Kenta Murotani, Tatsuro Inoue, Shinsuke Nagami, Mizue Suzuki, Keisuke Maeda
Clinical Nutrition.2023; 42(9): 1595. CrossRef
Sarcopenia as a prognostic indicator in colorectal cancer: an updated meta-analysis
Jie He, Wei Luo, Yuanyuan Huang, Lingmeng Song, Yang Mei
Frontiers in Oncology.2023;[Epub] CrossRef
Sarcopenia, Precardial Adipose Tissue and High Tumor Volume as Outcome Predictors in Surgically Treated Pleural Mesothelioma
Oliver Guido Verhoek, Lisa Jungblut, Olivia Lauk, Christian Blüthgen, Isabelle Opitz, Thomas Frauenfelder, Katharina Martini
Diagnostics.2022; 12(1): 99. CrossRef
Skeletal muscle wasting and long-term prognosis in patients undergoing rectal cancer surgery without neoadjuvant therapy
Alessandro Giani, Simone Famularo, Alessandro Fogliati, Luca Riva, Nicolò Tamini, Davide Ippolito, Luca Nespoli, Marco Braga, Luca Gianotti
World Journal of Surgical Oncology.2022;[Epub] CrossRef
Value-added Opportunistic CT Screening: State of the Art
Perry J. Pickhardt
Radiology.2022; 303(2): 241. CrossRef
Sarcopenic obesity: What about in the cancer setting?
Gianluca Gortan Cappellari, Caterina Brasacchio, Daniela Laudisio, Carla Lubrano, Francesca Pivari, Luigi Barrea, Giovanna Muscogiuri, Silvia Savastano, Annamaria Colao
Nutrition.2022; 98: 111624. CrossRef
CT-Derived Body Composition Assessment as a Prognostic Tool in Oncologic Patients: From Opportunistic Research to Artificial Intelligence–Based Clinical Implementation
David D. B. Bates, Perry J. Pickhardt
American Journal of Roentgenology.2022; 219(4): 671. CrossRef
Prevalence and prognostic value of sarcopenic obesity in patients with cancer: A systematic review and meta-analysis
Qianqian Gao, Kaiyan Hu, Jing Gao, Yi Shang, Fan Mei, Li Zhao, Fei Chen, Bin Ma
Nutrition.2022; 101: 111704. CrossRef
Prognostic value of sarcopenia in patients with rectal cancer: A meta-analysis
Yueli Zhu, Xiaoming Guo, Qin Zhang, Yunmei Yang, Zubing Mei
PLOS ONE.2022; 17(6): e0270332. CrossRef
A systematic review and meta-analysis assessing the impact of body mass index on long-term survival outcomes after surgery for colorectal cancer
Constantinos Simillis, Beth Taylor, Ayesha Ahmad, Nikhil Lal, Thalia Afxentiou, Michael P. Powar, Elizabeth C. Smyth, Nicola S. Fearnhead, James Wheeler, Richard J. Davies
European Journal of Cancer.2022; 172: 237. CrossRef
Sarcobesity Index Predicts Poor Disease-Specific Survival After Resection for Colorectal Cancer
Cristian Conti, Giulia Turri, Gabriele Gecchele, Simone Conci, Giulia A. Zamboni, Andrea Ruzzenente, Alfredo Guglielmi, Corrado Pedrazzani
Journal of Surgical Research.2022; 279: 398. CrossRef
Sarcopenic obesity and therapeutic outcomes in gastrointestinal surgical oncology: A meta-analysis
Peiyu Wang, Shaodong Wang, Yi Ma, Haoran Li, Zheng Liu, Guihu Lin, Xiao Li, Fan Yang, Mantang Qiu
Frontiers in Nutrition.2022;[Epub] CrossRef
Adiposity and cancer survival: a systematic review and meta-analysis
En Cheng, Jocelyn Kirley, Elizabeth M. Cespedes Feliciano, Bette J. Caan
Cancer Causes & Control.2022; 33(10): 1219. CrossRef
Obesity may not be related to pathologic response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy
Quoc Riccardo Bao, Filippo Crimì, Giovanni Valotto, Valentina Chiminazzo, Francesca Bergamo, Alessandra Anna Prete, Sara Galuppo, Badr El Khouzai, Emilio Quaia, Salvatore Pucciarelli, Emanuele Damiano Luca Urso
Frontiers in Oncology.2022;[Epub] CrossRef
Lifestyle interventions after colorectal cancer surgery using a mobile digital device: A study protocol for a randomized controlled trial
Young Il Kim, In Ja Park, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim, Yura Lee, Harin Kim, Seockhoon Chung, Chang-Min Choi, Hui Jeong Lee, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
Medicine.2022; 101(41): e31264. CrossRef
Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease
Ji Young Lee, Kyung Won Kim, Yousun Ko, Chi Hyuk Oh, Bo Hyun Kim, Seong Jin Park, Myung-Won You
Diagnostics.2022; 12(11): 2804. CrossRef
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Erik Haehl, Luisa Alvino, Alexander Rühle, Jiadai Zou, Alexander Fabian, Anca-Ligia Grosu, Nils H. Nicolay
Cancers.2022; 14(22): 5536. CrossRef
Marked loss of adipose tissue during neoadjuvant therapy as a predictor for poor prognosis in patients with gastric cancer: A retrospective cohort study
Yingjing Zhang, Zijian Li, Lin Jiang, Zhigang Xue, Zhiqiang Ma, Weiming Kang, Xin Ye, Yuqin Liu, Zhengyu Jin, Jianchun Yu
Journal of Human Nutrition and Dietetics.2021; 34(3): 585. CrossRef
Sarcopenia predicts worse postoperative outcomes and decreased survival rates in patients with colorectal cancer: a systematic review and meta-analysis
Mario Trejo-Avila, Katya Bozada-Gutiérrez, Carlos Valenzuela-Salazar, Jesús Herrera-Esquivel, Mucio Moreno-Portillo
International Journal of Colorectal Disease.2021; 36(6): 1077. CrossRef
Prognostic and predictive value of neutrophil-to-lymphocyte ratio after curative rectal cancer resection: A systematic review and meta-analysis
Hytham K.S. Hamid, George N. Davis, Mario Trejo-Avila, Patrick O. Igwe, Andrés Garcia-Marín
Surgical Oncology.2021; 37: 101556. CrossRef
The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications
Erika Aparecida Silveira, Rômulo Roosevelt da Silva Filho, Maria Claudia Bernardes Spexoto, Fahimeh Haghighatdoost, Nizal Sarrafzadegan, Cesar de Oliveira
International Journal of Molecular Sciences.2021; 22(9): 4339. CrossRef
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Cancers.2021; 13(10): 2410. CrossRef
Preoperative computed tomography-assessed sarcopenia as a predictor of complications and long-term prognosis in patients with colorectal cancer: a systematic review and meta-analysis
Hailun Xie, Lishuang Wei, Mingxiang Liu, Guanghui Yuan, Shuangyi Tang, Jialiang Gan
Langenbeck's Archives of Surgery.2021; 406(6): 1775. CrossRef
Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review
Antti Tolonen, Tomppa Pakarinen, Antti Sassi, Jere Kyttä, William Cancino, Irina Rinta-Kiikka, Said Pertuz, Otso Arponen
European Journal of Radiology.2021; 145: 109943. CrossRef
Skeletal muscle gauge as a prognostic factor in patients with colorectal cancer
In Kyu Park, Song Soo Yang, Eric Chung, Eun‐Suk Cho, Hye Sun Lee, Su‐Jin Shin, Yeong Cheol Im, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Cancer Medicine.2021; 10(23): 8451. CrossRef
Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review
Xiao-Ming Zhang, Qing-Li Dou, Yingchun Zeng, Yunzhi Yang, Andy S. K. Cheng, Wen-Wu Zhang
BMC Cancer.2020;[Epub] CrossRef
Sarcopenia Is Associated With Hematologic Toxicity During Chemoradiotherapy in Patients With Anal Carcinoma
Daniel Martin, Jens von der Grün, Claus Rödel, Emmanouil Fokas
Frontiers in Oncology.2020;[Epub] CrossRef

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