Association between muscle mass/strength loss and healthcare costs/quality of life for patients with colorectal cancer: results from the ongoing longitudinal EnCoRe Study

Abstract Purpose: To assess the associations between muscle parameters of colorectal cancer (CRC) patients and costs/Quality-Adjusted Life-Years (QALYs). Methods: CRC patients from the ‘Energy for Life after ColoRectal Cancer’ (EnCoRe) study in the Netherlands were included. Muscle strength and mid-upper arm muscle circumference (MUAMC) were considered and two-year total societal costs and QALYs were measured. Linear multiple regressions were used to measure the associations between baseline muscle parameters and total two-year costs/QALYs. Linear mixed-model regressions were used to assess? the associations between muscle parameters evolution and total two-year costs/QALYs. Results: 194 (133 men, 61 women; mean age 65.9 years) participants were included in the analyses. Lower values of muscle strength and MUAMC at baseline seem to be predictive of higher outpatient costs and higher treatment costs, respectively. In longitudinal analyses, the decrease of muscle strength over two years was associated with higher outpatient cost and the decrease of MUAMC was associated with higher treatment costs. No other significant associations between baseline muscle parameters or evolution of these muscle parameters and costs were found. Regarding QALYs, a two-year decrease of muscle strength seems to be associated with lower QALYs. However, a two-year decline of MUAMC was associated with higher QALYs. Conclusion: Some limited associations were found between muscle parameters and costs/QALYs of CRC patients. The present analyses are however limited by the low variations of muscle parameters over time. Indeed, only a limited decrease of muscle strength was observed in the cohort study. Further longitudinal studies would be needed to investigate the relationships between muscle mass, muscle strength and costs of patients suffering from cancer more profoundly. Implications for cancer survivors: Even if results revealed limited evidence to suggest associations between muscle parameters and costs/QALYs in cancer patients, lower values of muscle strength and MUACM seems to be predictive of higher treatment costs. Targeting muscle parameters in cancer treatment rehabilitation may decrease further treatment costs of CRC patients.