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Comorbidity, body composition and the progression of advanced colorectal cancer Open Access


Other title
resting energy expenditure
body composition
cancer cachexia
ICD codes
Charlson comorbidity index
Elixhauser comorbidity index
computed tomography imaging
weight loss
colorectal cancer
liver metastases
Type of item
Degree grantor
University of Alberta
Author or creator
Lieffers, Jessica
Supervisor and department
Baracos, Vickie (Oncology and Agricultural, Food and Nutritional Science)
Examining committee member and department
McCargar, Linda (Agricultural, Food and Nutritional Science)
Fassbender, Konrad (Oncology)
Department of Agricultural, Food, and Nutritional Science

Date accepted
Graduation date
Master of Science
Degree level
The purpose of this work was to further understand nutritional status, especially body weight and composition, during colorectal cancer progression. Population-based studies of colorectal cancer patients were conducted using administrative health data (primary and co-morbid diseases, demographics), and computed tomography (CT) imaging (body composition). In cohort 1, administrative health data was used to study comorbidities and nutritional status in 574 colorectal cancer patients referred for chemotherapy. Multivariate Cox regression revealed several comorbidities, performance status and weight loss ≥ 20% predicted survival. In cohort 2, a serial CT image analysis assessed longitudinal body composition changes during the last 12 months preceding death from colorectal cancer (n=34). Body composition changes were typified by exponential increases in liver metastases with concurrent accelerations of muscle and fat loss. These results have the potential to make a difference in how colorectal cancer patients are treated and researched by dietitians, oncologists, and health services researchers.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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