The impact of muscle mass loss and deteriorating physical function on prognosis in patients receiving hemodialysis

AbstractMuscle mass loss and worsening physical function are crucial issues in patients receiving hemodialysis (HD). However, few studies have investigated the association between temporal changes in muscle mass and physical function in a large number of HD patients. We examined 286 patients receiving HD (males, 58%; age, 66.8 ± 13.0 years) at a single center, and calculated the percent changes in psoas muscle mass index (%PMI) using computed tomography over two screenings, once per year (July 2011–June 2013). Physical function was evaluated using the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) (range 0–4). The observation period was from July 2012 to June 2021. The median %PMI was -9.5%, and those with the lowest quartile of %PMI (< −20.5%) showed a significantly poor prognosis compared with other patients (p < 0.001). Multivariable logistic regression analysis revealed that these patients tended to have decreased physical function (ECOG-PS 2–4) [odds ratio (OR): 2.46, p < 0.001] and albumin levels (OR: 0.22, p = 0.007). Multiple-factor-adjusted Cox regression analyses showed that %PMI (hazard ratio: 0.99, p = 0.004) and each ECOG-PS stage (1–4 vs. 0) (p < 0.01) were associated with mortality. Augmenting physical activities in daily life and serum albumin levels should be considered to maintain muscle mass and improve the prognosis of patients receiving HD.

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Myosteatosis as a novel prognostic biomarker after radical cystectomy for bladder cancer

Scientific Reports ◽

10.1038/s41598-020-79340-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Shimpei Yamashita ◽

Yuya Iwahashi ◽

Haruka Miyai ◽

Takashi Iguchi ◽

Hiroyuki Koike ◽

...

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Cox Regression ◽

Group Performance ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Psoas Muscle ◽

Hounsfield Units ◽

Computed Tomography Images ◽

Psoas Muscles

AbstractThis study aims to evaluate the influence of myosteatosis on survival of patients after radical cystectomy (RC) for bladder cancer. We retrospectively identified 230 patients who underwent RC for bladder cancer at our three institutions between 2009 and 2018. Digitized free-hand outlines of the left and right psoas muscles were made on axial non-contrast computed tomography images at level L3. To assess myosteatosis, average total psoas density (ATPD) in Hounsfield Units (HU) was also calculated as an average of bilateral psoas muscle density. We compared cancer-specific survival (CSS) between high ATPD and low ATPD groups and performed cox regression hazard analyses to identify the predictors of CSS. Median ATPD was 44 HU (quartile: 39–47 Hounsfield Units). Two-year CSS rate in overall patients was 76.6%. Patients with low ATPD (< 44 HU) had significantly lower CSS rate (P = 0.01) than patients with high ATPD (≥ 44 HU). According to multivariate analysis, significant independent predictors of poor CSS were: Eastern Cooperative Oncology Group performance status ≥ 1 (P = 0.03), decreasing ATPD (P = 0.03), non-urothelial carcinoma (P = 0.01), pT ≥ 3 (P < 0.01), and pN positive (P < 0.01). In conclusion, myosteatosis (low ATPD) could be a novel predictor of prognosis after RC for bladder cancer.

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Loss of skeletal muscle mass affects the incidence of minimal hepatic encephalopathy: A case control study

10.21203/rs.3.rs-42056/v3 ◽

2020 ◽

Author(s):

Masakuni Tateyama ◽

Hideaki Naoe ◽

Motohiko Tanaka ◽

Kentaro Tanaka ◽

Satoshi Narahara ◽

...

Keyword(s):

Skeletal Muscle ◽

Hepatic Encephalopathy ◽

Mass Loss ◽

Muscle Mass ◽

Odds Ratio ◽

Skeletal Muscle Mass ◽

Psoas Muscle ◽

Minimal Hepatic Encephalopathy ◽

Muscle Area ◽

Muscle Mass Loss

Abstract Background: Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE).Methods: To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis.Methods: Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume.Results: This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm2/m2) than in those without (5.53 cm2/m2, P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm2/m2; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm2/m2; odds ratio 0.192, P = 0.001).Conclusions: Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

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The effect of anti-IGF1 therapy on muscle mass in metastatic pancreatic cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.4064 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 4064-4064

Author(s):

David R. Fogelman ◽

Mohamed Aly Khalil ◽

Manal Hassan ◽

Naveen Garg ◽

Milind M. Javle ◽

...

Keyword(s):

Pancreatic Cancer ◽

Mass Loss ◽

Muscle Mass ◽

Drop Out ◽

Metastatic Pancreatic Cancer ◽

Muscle Area ◽

Multiple Tumor ◽

Muscle Mass Loss ◽

Tumor Types ◽

The Impact

4064 Background: IGF-1 plays a role in the growth of multiple tumor types, including pancreatic cancer. IGF-1 also serves as a growth factor for muscle. The impact of therapeutic targeting of IGF-1 on muscle mass is unknown. Methods: We evaluated muscle mass at L3 in patients enrolled in a randomized phase II study of MK-0646 (M), a monoclonal antibody directed against the IGF-1 protein, in patients with metastatic pancreatic cancer (MPC). We used the Slice-o-matic (ver 4.3) software to segregate CT images into muscle and fat components and measured muscle area (cm2) at baseline and after 2 and 4 months of treatment. Patients received either gemcitabine with erlotinib (G+E), G+E+M, or G+M. Differences between the groups were compared using t-tests. Results: 58 patients had both baseline and 2 month imaging available for analysis. Of these, 44 received M and 14 had G+E only. Baseline muscle mass between the two groups was similar: 146 cm2 and 142 cm2, respectively (P=0.47). After two months of treatment, both groups demonstrated decrease in muscle mass: 134 cm2 (8% loss) vs. 130 cm2 (6% loss) (P= 0.19). Of the 37 patients who had either PR or SD at 2 months, there was a non-significant increase in muscle mass loss among the patients receiving M (7.8% vs. 4.5%, p=.31). At 4 months, those remaining patients in the M group lost 6% (n=14) of muscle mass compared to 3% in the non-M group (n=5) (P=0.54). Each 1% loss of muscle mass increased the odds of dropout by 13% (p=.03, CI 1.0-27%) and predicted for poor survival (p=HR 1.08, p=.02). Conclusions: MPC patients can be expected to lose muscle mass even while having clinical benefit (PR or SD) from chemotherapy. Muscle loss correlated with a risk of study drop-out and death. There was a non-significant trend towards greater muscle mass loss in patients on anti-IGF-1R therapy. However, it is unclear if this loss translates into functional differences between patients. Clinical trial information: NCT00769483.

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The impact of muscle mass loss after esophagectomy for esophageal cancer on prognosis.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.107 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 107-107

Author(s):

Yota Shimoda ◽

Takashi Ogata ◽

Shinsuke Nagasawa ◽

Yuta Kumazu ◽

Tsutomu Hayashi ◽

...

Keyword(s):

Esophageal Cancer ◽

Mass Loss ◽

Muscle Mass ◽

Complication Rate ◽

Perioperative Period ◽

Cox Regression Analysis ◽

Group A ◽

Muscle Mass Loss ◽

Group B ◽

The Impact

107 Background: Several reports revealed that preoperative presence of sarcopenia was related with poor prognosis for esophageal cancer. However, the influence of muscle mass loss during perioperative period on prognosis is unknown. The alternation of muscle mass during perioperative period is attractive topic as surgeon have chance to intervene for maintaining muscle mass in perioperative care. The aim of this study was to assess the influence of loss of muscle after esophagectomy to discharge on prognosis. Methods: This study retrospectively analyzed 150 consecutive patients with esophageal and gastroesophageal junction cancer, who underwent the open right thoraco−abdominal approach esophagectomy, pathologically diagnosed as squamous cell carcinoma or adenocarcinoma, between September 2011 and June 2015. Patients who had pathologically diagnosed as T4 or stageⅣ according to the UICC 7th edition TNM classification were excluded. This study investigated the influence of muscle mass loss after esophagectomy to discharge on prognosis. Body composition was analyzed using the Tanita MC−190EM bioelectrical impedance analyzer, evaluated within 1 week before surgery and at discharge. The primary end−point is over−all survival after esophagectomy. Results: The median % muscle mass loss was 4.38% (range −3.3 to +18.8). Patients were divided into two groups based on the % muscle mass loss by cut−off 4.38 (group A: less % muscle mass loss, group B: more % muscle mass loss). N stage (0/1/2/3) was 39/28/6/2 in group A, and 26/23/19/7 in group B. The rate of 2/3 was significantly higher in group B. Postoperative complication rate was 31% (23/75) in group A, and 48% (36/75) in group B. The complication rate was significantly higher in group B. The 3−years survival rate was 89.2% in group A, and 70.9% in group B. Group B was significantly worse for over−all survival than group A (p = 0.033). Multivariate Cox regression analysis showed that the patients who had % muscle mass loss over 4.38 (p = 0.045; HR 2.008; HR 95% CI 1.014−3.977), T2/3 (p = 0.001; HR 3.649; HR 95% CI 1.660−8.019) associated with worse over−all survival. Conclusions: Our study found correlation between loss of muscle after esophagectomy to discharge and worse outcomes.

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Mo1358 THE IMPACT OF SKELETAL MUSCLE MASS LOSS IN PATIENTS WITH ADVANCED PANCREATIC CANCER DURING FOLFIRINOX

Gastroenterology ◽

10.1016/s0016-5085(20)32835-3 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-863

Author(s):

Shinya Uemura ◽

Takuji Iwashita ◽

Hironao Ichikawa ◽

Yuhei Iwasa ◽

Naoki Mita ◽

...

Keyword(s):

Skeletal Muscle ◽

Pancreatic Cancer ◽

Mass Loss ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Advanced Pancreatic Cancer ◽

Muscle Mass Loss ◽

The Impact

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Loss of skeletal muscle mass affects the incidence of minimal hepatic encephalopathy: A case control study

10.21203/rs.3.rs-42056/v2 ◽

2020 ◽

Author(s):

Masakuni Tateyama ◽

Hideaki Naoe ◽

Motohiko Tanaka ◽

Kentaro Tanaka ◽

Satoshi Narahara ◽

...

Keyword(s):

Skeletal Muscle ◽

Hepatic Encephalopathy ◽

Mass Loss ◽

Muscle Mass ◽

Odds Ratio ◽

Skeletal Muscle Mass ◽

Psoas Muscle ◽

Minimal Hepatic Encephalopathy ◽

Muscle Area ◽

Muscle Mass Loss

Abstract Background: Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE). Methods: To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis. Methods: Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume. Results: This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm 2 /m 2 ) than in those without (51.2 cm 2 /m 2 , P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm 2 /m 2 ) than in those without (5.53 cm 2 /m 2 , P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm 2 /m 2 ; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm 2 /m 2 ; odds ratio 0.192, P = 0.001).Conclusions: Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

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Loss of skeletal muscle mass affects the incidence of minimal hepatic encephalopathy: a case control study

BMC Gastroenterology ◽

10.1186/s12876-020-01501-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Masakuni Tateyama ◽

Hideaki Naoe ◽

Motohiko Tanaka ◽

Kentaro Tanaka ◽

Satoshi Narahara ◽

...

Keyword(s):

Skeletal Muscle ◽

Hepatic Encephalopathy ◽

Mass Loss ◽

Muscle Mass ◽

Odds Ratio ◽

Skeletal Muscle Mass ◽

Psoas Muscle ◽

Minimal Hepatic Encephalopathy ◽

Muscle Area ◽

Muscle Mass Loss

Abstract Background Sarcopenia is a syndrome characterized by progressive and systemic decreases in skeletal muscle mass and muscle strength. The influence or prognosis of various liver diseases in this condition have been widely investigated, but little is known about whether sarcopenia and/or muscle mass loss are related to minimal hepatic encephalopathy (MHE). Methods To clarify the relationship between MHE and sarcopenia and/or muscle mass loss in patients with liver cirrhosis. Methods Ninety-nine patients with liver cirrhosis were enrolled. MHE was diagnosed by a neuropsychiatric test. Skeletal mass index (SMI) and Psoas muscle index (PMI) were calculated by dividing skeletal muscle area and psoas muscle area at the third lumbar vertebra by the square of height in meters, respectively, to evaluate muscle volume. Results This study enrolled 99 patients (61 males, 38 females). MHE was detected in 48 cases (48.5%) and sarcopenia in 6 cases (6.1%). Patients were divided into two groups, with or without MHE. Comparing groups, no significant differences were seen in serum ammonia concentration or rate of sarcopenia. SMI was smaller in patients with MHE (46.4 cm2/m2) than in those without (51.2 cm2/m2, P = 0.027). Similarly, PMI was smaller in patients with MHE (4.24 cm2/m2) than in those without (5.53 cm2/m2, P = 0.003). Skeletal muscle volume, which is represented by SMI or PMI was a predictive factor related to MHE (SMI ≥ 50 cm2/m2; odds ratio 0.300, P = 0.002, PMI ≥ 4.3 cm2/m2; odds ratio 0.192, P = 0.001). Conclusions Muscle mass loss was related to minimal hepatic encephalopathy, although sarcopenia was not. Measurement of muscle mass loss might be useful to predict MHE.

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Impact of prior docetaxel (D) on sipuleucel-T (sip-T) product parameters in PROCEED patients (pts).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5034 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5034-5034 ◽

Cited By ~ 4

Author(s):

Celestia S. Higano ◽

Andrew J. Armstrong ◽

Matthew R. Cooperberg ◽

Philip W. Kantoff ◽

James Bailen ◽

...

Keyword(s):

Group Performance ◽

Performance Status ◽

Eastern Cooperative Oncology Group ◽

Cellular Immunotherapy ◽

Ecog Ps ◽

Antigen Presenting ◽

The Impact ◽

Manufacturing Parameters ◽

Ongoing Phase ◽

Clinical Trial Information

5034 Background: Sip-T is an autologous cellular immunotherapy indicated for asymptomatic or minimally symptomatic mCRPC. The IMPACT trial excluded pts who received D ≤3 months prior to registration. PROCEED is an ongoing, phase IV registry, enrolling pts treated with commercial sip-T. Use of D prior to sip-T is not restricted, so prior D affect on sip-T immune manufacturing parameters can be evaluated. Methods: Pts treated with sip-T ≤ 6 mo were eligible to provide informed consent. Sip-T parameters assessed included: total nucleated cell (TNC) count, antigen presenting cell (APC) count (CD54+large cells) and APC activation (upregulation of CD54). Results: By Nov. 2012, 108/761 (14%) received D prior to sip-T and had similar median cumulative APC counts (1.83 [Q1, Q3: 1.16, 2.71] vs. 1.82 [1.27, 2.70] x 109) and TNC counts (10.16 [7.30, 13.69] vs. 11.47 [8.56, 15.31] x 109) vs. D naïve, whereas median cumulative APC activation appeared slightly lower (32.39 [25.05, 41.02] vs. 34.84 [28.71, 42.83]), but was well above the release criterion for each infusion (2.6 fold). The group was then split by Eastern Cooperative Oncology Group Performance Status (ECOG PS) and Gleason scores (Table). Conclusions: Pts with D prior to sip-T appeared to have product parameters comparable to pts without prior D, albeit with a slightly lower APC activation. Further analysis showed that pts receiving D within 3 months of sip-T had higher Gleason and ECOG scores. The clinical significance of these findings is unclear, but suggests that APC activation is not impaired following docetaxel. Clinical trial information: NCT01306890. [Table: see text]

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