scholarly journals Prognostic value of low skeletal muscle mass in patient treated by exclusive curative radiochemotherapy for a NSCLC

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
R. Mallet ◽  
P. Decazes ◽  
R. Modzelewski ◽  
J. Lequesne ◽  
P. Vera ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Body Mass ◽  
Visceral Fat ◽  
Prognostic Value ◽  
Skeletal Muscle Mass ◽  
Pet Ct ◽  
Cox Analysis

AbstractLow skeletal muscle mass is a well-known prognostic factor for patients treated for a non-small-cell lung cancer by surgery or chemotherapy. However, its impact in patients treated by exclusive radiochemotherapy has never been explored. Our study tries to evaluate the prognostic value of low skeletal muscle mass and other antropometric parameters on this population. Clinical, nutritional and anthropometric date were collected for 93 patients treated by radiochemotherapy for a NSCLC. Anthropometric parameters were measured on the PET/CT by two methods. The first method was a manual segmentation at level L3, used to define Muscle Body Area (MBAL3), Visceral Fat Area (VFAL3) and Subcutaneous Fat Area (SCFAL3). The second method was an software (Anthropometer3D), allowing an automatic multislice measurement of Lean Body Mass (LBMAnthro3D), Fat Body Mass (FBMAnthro3D), Muscle Body Mass (MBMAnthro3D), Visceral Fat Mass (VFMAnthro3D), and Sub-Cutaneous Fat Mass (SCFMAnthro3D) on the PET/CT. All anthropometrics parameters were normalised by the patient's height. The primary end point was overall survival time. Univariate and then stepwise multivariate cox analysis were performed for significant parameters. Finally, Spearman's correlation between MBAL3 and MBMAnthro3D was assessed. Forty-one (44%) patients had low skeletal muscle mass. The median overall survival was 18 months for low skeletal muscle mass patients versus 36 months for non-low skeletal muscle mass patients (p = 0.019). Low skeletal muscle mass (HR = 1.806, IC95% [1.09–2.98]), serums albumin level < 35 g/l (HR = 2.203 [1.19–4.09]), Buzby Index < 97.5 (HR = 2.31 [1.23–4.33]), WHO score = 0 (HR = 0.59 [0.31–0.86] and MBMAnthro3D < 8.56 kg/m2 (HR = 2.36 [1.41–3.90]) were the only significant features in univariates analysis. In the stepwise multivariate Cox analysis, only MBMAnthro3D < 8.56 kg/m2 (HR = 2.16, p = 0.003) and WHO score = 0 (HR = 0.59, p = 0.04) were significant. Finally, muscle quantified by MBAL3 and MBMAnthro3D were found to be highly correlated (Spearman = 0.9). Low skeletal muscle mass, assessed on the pre-treatment PET/CT is a powerful prognostic factor in patient treated by radiochemotherapy for a NSCLC. The automatic software Anthropometer3D can easily identify patients a risk that could benefit an adapted therapy.

scholarly journals The predictive and prognostic value of low skeletal muscle mass for dose-limiting toxicity and survival in head and neck cancer patients receiving concomitant cetuximab and radiotherapy

2020 ◽  
Vol 277 (10) ◽  
pp. 2847-2858 ◽  
Author(s):  
L. F. J. Huiskamp ◽  
N. Chargi ◽  
L. A. Devriese ◽  
P. A. de Jong ◽  
R. de Bree
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Head And Neck ◽  
Muscle Mass ◽  
Predictive Value ◽  
Prognostic Value ◽  
Skeletal Muscle Mass ◽  
Cervical Vertebra ◽  
Kaplan Meier ◽  
Dose Limiting Toxicity

Abstract Purpose This study aims to investigate the predictive value of low skeletal muscle mass (SMM) for cetuximab dose-limiting toxicity (DLT) and its prognostic value in head and neck squamous cell carcinoma (HNSCC) patients treated with concomitant cetuximab and radiotherapy. Methods Patients diagnosed with HNSCC and treated with primary or adjuvant concomitant cetuximab and radiotherapy were included. Clinical and demographic variables were retrospectively retrieved and SMM was measured at the level of the third cervical vertebra using pre-treatment diagnostic computed tomography or magnetic resonance imaging. An optimal cut-off value for low SMM was determined based on the lowest log-likelihood associated with cetuximab DLT. A multivariate linear regression model was used to determine predictive factors for cetuximab DLT. The prognostic value of low SMM for disease-free and overall survival was analyzed using Kaplan–Meier curves. Results The optimal cut-off value for low SMM as a predictor of cetuximab DLT was an LSMI ≤ 45.2 cm2/m2. Of the 91 included patients, 74.7% had low SMM and 30.8% experienced cetuximab DLT. At multivariate analysis, low SMM had no predictive value for DLT (OR 0.83; 95% CI 0.27–2.56; p = 0.74). The Kaplan–Meier curve demonstrated that patients with low SMM had significantly lower overall survival (Log Rank χ2 = 5.87; p = 0.02). Conclusion Low SMM is highly prevalent in HNSCC patients treated with concomitant cetuximab and radiotherapy. Low SMM has no predictive value for cetuximab DLT in HNSCC patients. Low SMM is probably not a prognostic factor for overall survival in highly selected HNSCC patients treated with concomitant cetuximab and radiotherapy and unfit for platin-based chemotherapy.

scholarly journals Dietary-Lifestyle Patterns Associated with Adiposity and Metabolic Abnormalities in Adult Men under 40 Years Old: A Cross-Sectional Study (MeDiSH Project)

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 751
Author(s):  
Marta Lonnie ◽  
Lidia Wadolowska ◽  
Elzbieta Bandurska-Stankiewicz
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Visceral Fat ◽  
Central Obesity ◽  
Skeletal Muscle Mass ◽  
Metabolic Abnormalities ◽  
Fat Tissue ◽  
General Obesity ◽  
Lower Odds ◽  
Lifestyle Behaviours

The aim of this study was to examine the associations of dietary-lifestyle patterns (DLPs) with adiposity and metabolic abnormalities in adult Polish men that were under 40. The cross-sectional study included 358 men that were 19–40-year-old. Dietary and lifestyle data were collected with multicomponent food frequency questionnaire (KomPAN®). DPLs were derived with Principal Component Analysis (PCA) using 25 dietary and six lifestyle as the input variables. Adiposity was determined with the use of: overweight (body mass index 25–29.9 kg/m2), central obesity (waist-to-height ratio ≥ 0.5), general obesity (body fat ≥ 25%), excessive visceral fat tissue (≥ median), and increased skeletal muscle mass (≥ median). The metabolic abnormalities were characterised by elevated: fasting blood glucose (FBG ≥ 100 mg/dL), triglycerides (TG ≥ 150 mg/dL), total cholesterol (TC ≥ 200 mg/dL), or systolic or diastolic blood pressure (≥ 130 or ≥ 85 mmHg, respectively). Four PCA-driven DLPs were derived and labelled accordingly to the most characteristic dietary or lifestyle behaviours that were correlated with each pattern. Multivariate logistic regression revealed that higher adherence (upper vs. bottom tertile as referent) to “Protein food, fried-food, and recreational physical activity” pattern was associated with higher odds of overweight and increased skeletal muscle mass, and lower odds of: general obesity, excessive visceral fat tissue, and elevated TC. Higher adherence to “Healthy diet, active, past smokers” pattern was associated with higher odds of overweight and lower odds of: general obesity, excessive visceral fat tissue, and elevated FBG. Higher adherence to “Sandwiches and convenient diet” pattern was associated with higher odds of: central obesity, general obesity, excessive visceral fat tissue, elevated TC, elevated TG, occurrence at least two metabolic abnormalities, and lower odds of increased skeletal muscle mass. A higher adherence to “Fast foods and stimulants” pattern was associated with higher odds of central obesity, general obesity, excessive visceral fat tissue, and lower odds of increased skeletal muscle mass. The interrelations between diet and lifestyle behaviours were reflected in three out of four patterns. Healthy diet attempts combined with active lifestyle was associated with reduced risk of adiposity and metabolic abnormalities despite some unhealthy components, like former smoking or fried-food consumption. In contrary, patterns that were composed of undesirable dietary behaviours solely, as well as poor diet combined with stimulant use, were associated with higher adiposity and worse metabolic health, despite the relatively young age of the study participants. Accurate mapping of dietary-lifestyle behaviours can serve as a tool for formulating evidence-based recommendations.

scholarly journals Early loss of skeletal muscle mass (LSMM) as prognostic factor in metastatic pancreatic cancer (PC) patients

2017 ◽  
Vol 28 ◽  
pp. vi49
Author(s):  
D. Basile ◽  
A. Parnofiello ◽  
M.G. Vitale ◽  
F. Cortiula ◽  
S.K. Garattini ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Metastatic Pancreatic Cancer ◽  
Early Loss

Sarcopenia and altered body composition following abiraterone acetate (AA) and corticosteroid (C) treatment in men with castration-refractory prostate cancer (CRPC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15134-e15134
Author(s):  
Deborah Mukherji ◽  
Carmel Jo Pezaro ◽  
Diletta Bianchini ◽  
Nina Tunariu ◽  
Amy Mulick Cassidy ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Median Duration ◽  
Visceral Fat ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Advanced Malignancy ◽  
Total Fat

e15134 Background: Sarcopenia, or skeletal muscle wasting, is an independent prognostic factor in advanced malignancy (Prado Lancet Onc 2008). Decreased muscle and increased fat are recognized side effects of androgen deprivation therapy. AA is a CYP17 inhibitor administered with corticosteroids (C), approved for treatment of advanced CRPC. AA reduces circulating androgens to ‘super-castrate’ levels; we hypothesized that AA + C would impact body composition. Methods: We retrospectively evaluated 54 CRPC pts treated on a Phase I/II trial. Pts received AA alone followed by combination AA + C on biochemical progression. CT scans at baseline, on AA alone and on AA + C were analyzed. Cross-sectional areas of fat and muscle were measured on 3 consecutive images at L4 using OsiriX 4.0. Muscle area was used to calculate skeletal muscle index (SMI); sarcopenia was defined as SMI <52.4 cm2/m2. Data were analyzed using t-tests and Kaplan-Meier analysis with overall survival (OS) measured from day 1 of AA. Results: Median duration on AA alone was 7.4 months (m; range 1.4-37.5); median duration on concurrent AA + C was 7.4m (range 0.9-46.2). Body composition did not change between two pre-treatment scans (n=29; median 3m apart). On AA alone there was a decrease in total fat (-8.5%, p=0.0001), visceral fat (-9.8%, p=0.0015) and muscle mass (-3.9%, p=0.0023) with a significant decrease in mean body mass index (BMI; -3.4 %, p=0.0118). Conversely AA + C was associated with increased total fat (+15.1%, p<0.0001) and visceral fat (+21.4%, p<0.0001) but no further change in muscle mass. Mean BMI significantly increased on the addition of C, returning to baseline levels (p< 0.0001). Overall, 13 pts (24%) were sarcopenic prior to commencing AA compared to 22 (41%) at the end of treatment. Pts who were sarcopenic at baseline had significantly reduced OS: 26.1m (95%CI 16.6 – 41) vs 46.5m (95%CI 28.6 – 57.5, p=0.0253). Conclusions: Treatment with AA alone resulted in decreased fat and muscle. AA + C increased body fat without further alteration in muscle mass. Changes in BMI did not reflect changes in body composition. Sarcopenia at baseline was a negative prognostic factor in this population.

scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu ◽  
Pierre Decazes ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Significant Prognostic Factor ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions

scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu New ◽  
Pierre Decazes ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Significant Prognostic Factor ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions

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