scholarly journals Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy: a retrospective observational study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
In-Ho Kim ◽  
Moon Hyung Choi ◽  
In Seok Lee ◽  
Tae Ho Hong ◽  
Myung Ah. Lee
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factors ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
First Line ◽  
Poor Overall Survival ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Muscle Density ◽  
Metastatic Pancreatic Adenocarcinoma

Abstract Background To investigate the clinical impact of sarcopenia and skeletal muscle density (SMD) among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy. Methods A total of 330 patients treated with first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included. CT scans before chemotherapy and after 8±2 weeks were evaluated. The L3 skeletal muscle index (SMI) was used to detect sarcopenia and calculated as the total area of the L3 skeletal muscle divided by the height-squared (cm2/m2). SMD was quantified as the mean muscle radiation attenuation of the muscle cross-sectional area across the L3 vertebral body level and was assessed between − 29 and + 150 Hounsfield units. Results A SMI to SMD comparison revealed a positive correlation (R2 = 0.058, P < 0.001). Compared with high SMD, the risks of low SMI were 1.516 (95% confidence interval [CI]: 1.164–1.973) among patients with low SMD. Kaplan–Meier analysis showed that the low SMD was related to poor overall survival (OS, median, 6.1 versus [vs.] 7.9 months, P = 0.010). Multivariate analysis using Cox regression showed that low SMI (hazard ratio [HR]: 1.35, 95% CI: 1.03–1.78, P = 0.032) and low SMD (HR: 1.45, 95% CI: 1.09–1.93, P = 0.011) were poor prognostic factors for OS, respectively. Co-presence of low SMI and low SMD had more powerful prognostic implication for OS (HR: 1.58, 95% CI: 1.12–2.23, P = 0.010). Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients who have a low SMI (43% vs. 59%, P = 0.019) and low SMD (44% vs. 60%, P = 0.023). OS was not related to SMD status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low SMD groups had significantly poorer OS in comparison with high SMD groups (median, 5.6 vs 7.4 months, P = 0.006). Conclusions Sarcopenia and SMD status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who received palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low SMD groups. Our data suggest that a comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.

scholarly journals Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy : a retrospective observational study.

2021 ◽  
Author(s):  
In-Ho Kim ◽  
Moon Hyung Choi ◽  
In Seok Lee ◽  
Tae Ho Hong ◽  
Myung Ah Lee
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factors ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
First Line ◽  
Poor Overall Survival ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Muscle Density ◽  
Metastatic Pancreatic Adenocarcinoma

Abstract Background: To investigate the clinical impact of sarcopenia and skeletal muscle density (SMD) among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy.Methods: A total of 330 patients treated with first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included. CT scans before chemotherapy and after 8±2 weeks were evaluated. The L3 skeletal muscle index (SMI) was used to detect sarcopenia and calculated as the total area of the L3 skeletal muscle divided by the height-squared (cm2/m2). SMD was quantified as the mean muscle radiation attenuation of the muscle cross-sectional area across the L3 vertebral body level and was assessed between -29 and +150 Hounsfield units. Results: A SMI to SMD comparison revealed a positive correlation (R2 = 0.058, P<0.001). Compared with high SMD, the risks of low SMI were 1.516 (95% confidence interval [CI]: 1.164-1.973) among patients with low SMD. Kaplan–Meier analysis showed that the low SMD was related to poor overall survival (OS, median, 6.1 versus [vs.] 7.9 months, P=0.010). Multivariate analysis using Cox regression showed that low SMI (hazard ratio [HR]: 1.35, 95% CI: 1.03–1.78, P=0.032) and low SMD (HR: 1.45, 95% CI: 1.09–1.93, P=0.011) were poor prognostic factors for OS, respectively. Co-presence of low SMI and low SMD had more powerful prognostic implication for OS (HR: 1.58, 95% CI: 1.12–2.23, P=0.010). Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients who have a low SMI (43% vs. 59%, P=0.019) and low SMD (44% vs. 60%, P=0.023). OS was not related to SMD status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low SMD groups had significantly poorer OS in comparison with high SMD groups (median, 5.6 vs 7.4 months, P=0.006).Conclusions: Sarcopenia and SMD status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who received palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low SMD groups. Our data suggest that a comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.

scholarly journals Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy: a retrospective observational study.

2020 ◽  
Author(s):  
In-Ho Kim ◽  
Moon Hyung Choi ◽  
In Seok Lee ◽  
Tae Ho Hong ◽  
Myung Ah Lee
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
First Line ◽  
Poor Overall Survival ◽  
Skeletal Muscle Index ◽  
Muscle Density ◽  
Metastatic Pancreatic Adenocarcinoma

Abstract Background To investigate the clinical impact of sarcopenia and skeletal muscle density among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy. Methods A total of 330 patients with metastatic pancreatic adenocarcinoma who were treated with palliative first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included in this study. Sarcopenia and skeletal muscle density status were identified by L3 vertebra level skeletal muscle index in cm 2 /m 2 and muscle attenuation in Hounsfield units using computed tomography. Results A skeletal muscle index to skeletal muscle density comparison revealed a positive correlation (R 2 = 0.058, P<0.001). Kaplan–Meier analysis showed that low skeletal muscle density was associated with poor overall survival. Multivariate analysis using Cox regression showed that low skeletal muscle index and low skeletal muscle density were poor prognostic factors for overall survival, respectively. Co-presence of low skeletal muscle index and low skeletal muscle density had more powerful prognostic implication for overall survival. Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients with low skeletal muscle index and low skeletal muscle density. Overall survival was not associated with skeletal muscle density status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low skeletal muscle density groups had significantly poorer overall survival than did the high skeletal muscle density groups. Conclusions Sarcopenia and skeletal muscle density status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who receive palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low skeletal muscle density groups. Our data suggest that comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.

scholarly journals Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy : a retrospective observational study.

2020 ◽  
Author(s):  
In-Ho Kim ◽  
Moon Hyung Choi ◽  
In Seok Lee ◽  
Tae Ho Hong ◽  
Myung Ah Lee
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Pancreatic Adenocarcinoma ◽  
Cox Regression ◽  
First Line ◽  
Poor Overall Survival ◽  
Skeletal Muscle Index ◽  
Muscle Density ◽  
Metastatic Pancreatic Adenocarcinoma

Abstract Background: To investigate the clinical impact of sarcopenia and skeletal muscle density among patients with metastatic pancreatic adenocarcinoma who underwent palliative first line gemcitabine-based chemotherapy.Methods: A total of 330 patients with metastatic pancreatic adenocarcinoma who were treated with palliative first line gemcitabine-based chemotherapy between January 2010 and March 2017 were included in this study. Sarcopenia and skeletal muscle density status were identified by L3 vertebra level skeletal muscle index in cm2/m2 and muscle attenuation in Hounsfield units using computed tomography.Results: A skeletal muscle index to skeletal muscle density comparison revealed a positive correlation (R2 = 0.058, P<0.001). Kaplan–Meier analysis showed that the low skeletal muscle density was related to poor overall survival. Multivariate analysis using Cox regression showed that low skeletal muscle index and low skeletal muscle density were poor prognostic factors for overall survival, respectively. Co-presence of low skeletal muscle index and low skeletal muscle density had more powerful prognostic implication for overall survival. Grade 3 or higher toxicity of chemotherapy was more frequently observed in patients who have a low skeletal muscle index and low skeletal muscle density. Overall survival was not related to skeletal muscle density status among patients who were chemotherapy responders (complete or partial responses). However, among non-responders (stable or progressive disease), low skeletal muscle density groups had significantly poorer overall survival in comparison with high skeletal muscle density groups.Conclusions: Sarcopenia and skeletal muscle density status can be considered a prognostic factor in patients with metastatic pancreatic adenocarcinoma who received palliative first line gemcitabine-based chemotherapy. Severe chemotherapy toxicity occurred in the sarcopenia and low skeletal muscle density groups. Our data suggest that a comprehensive assessment of skeletal muscle parameters may be more useful prognostic factors.

Skeletal muscle depletion to predict survival of patients with advanced biliary tract cancer undergoing palliative chemotherapy.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 460-460
Author(s):  
Kyoung Min Cho ◽  
Do-Youn Oh ◽  
Tae Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Weight ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Palliative Chemotherapy ◽  
Cross Sectional ◽  
Skeletal Muscle Index ◽  
Tract Cancer

460 Background: Reports regarding sarcopenia as a prognostic factor in advanced biliary tract cancer (BTC) are rare. Furthermore, no study has investigated the dynamics of body weight with body muscle mass as a prognostic factor in advanced BTC patients undergoing palliative chemotherapy. Hence, we investigated whether sarcopenia affects survival in patients with BTC, with a co-analysis of body weight loss and body mass index (BMI). Methods: We consecutively enrolled patients with advanced BTC who received palliative chemotherapy between 2003 and 2013. Total muscle cross-sectional area (cm2) at the L3 level assessed by computed tomography was analyzed. We defined sarcopenia as a skeletal muscle index (SMI) < 48.5 cm2/m2 (men) and < 39.5 cm2/m2(women) using ROC curves. Results: The proportion of patients with sarcopenia upon diagnosis was 52.4% and 42.2% for men and women, respectively. By multivariate analysis, sarcopenia at diagnosis and decreased SMI during chemotherapy ( P = 0.008 and P < 0.001, respectively) were poor prognostic factors for overall survival (OS). Subgroup analysis revealed that sarcopenic patients who were overweight or obese (BMI ≥ 25 kg/m2) showed worse OS ( P < 0.001). Additionally, patients with both decreased BMI and SMI during chemotherapy had worse OS ( P < 0.001). Furthermore, patients with decreased SMI had shorter survival regardless of change in BMI. However, for patients with SMI maintained during chemotherapy, decreased BMI had no effect on survival ( P = 0.576). Conclusions: Sarcopenia, sarcopenic obesity and muscle depletion during palliative chemotherapy are meaningful prognostic factors in advanced BTC. Considering muscle depletion with weight change could help to more accurately predict prognosis of patients with BTC.

scholarly journals Change in skeletal muscle index and its prognostic significance in patients who underwent successful conversion therapy for initially unresectable colorectal cancer: observational study

2020 ◽  
Vol 13 ◽  
pp. 175628482097119
Author(s):  
Hiroaki Nozawa ◽  
Shigenobu Emoto ◽  
Koji Murono ◽  
Yasutaka Shuno ◽  
Kazushige Kawai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Systemic Therapy ◽  
Skeletal Muscles ◽  
Prognostic Significance ◽  
Stage Iv ◽  
The Body ◽  
Conversion Therapy ◽  
Cross Sectional ◽  
Skeletal Muscle Index

Background: Systemic therapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is unknown how the body composition is changed by chemotherapy rendering unresectable CRC to resectable disease or how it affects the prognosis. This study aimed at elucidating the effects of systemic therapy on skeletal muscles and survival in stage IV CRC patients who underwent conversion therapy. Methods: We reviewed 98 stage IV CRC patients who received systemic therapy in our hospital. According to the treatment setting, patients were divided into the conversion, neoadjuvant chemotherapy (NAC), and palliation groups. The cross-sectional area of skeletal muscles at the third lumbar level and changes in the skeletal muscle index (SMI), defined as the area divided by height squared, during systemic therapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the conversion group. Results: The mean SMI increased by 9.4% during systemic therapy in the conversion group ( n = 38), whereas it decreased by 5.9% in the NAC group ( n = 18) and 3.7% in the palliation group ( n = 42, p < 0.0001). Moreover, patients with increased SMI during systemic therapy had a better overall survival (OS) than those whose SMI decreased in the conversion group ( p = 0.025). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio 0.25). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. On the other hand, a decrease in the SMI during systemic therapy was a negative prognostic factor in such patients.

scholarly journals Quality of life of patients with metastatic pancreatic adenocarcinoma initiating first-line chemotherapy in routine practice

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Berta Laquente ◽  
Teresa Macarulla ◽  
Cristina Bugés ◽  
Marta Martín ◽  
Carlos García ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Adenocarcinoma ◽  
Routine Practice ◽  
First Line ◽  
Metastatic Pancreatic Adenocarcinoma ◽  
Line Chemotherapy

Nutrient and food group intakes and skeletal muscle index in the Japanese elderly: a cross-sectional analysis of the NHNS 2017

2020 ◽  
Vol 23 (16) ◽  
pp. 2923-2931 ◽  
Author(s):  
Chika Okada ◽  
Emiko Okada ◽  
Hidemi Takimoto
Keyword(s):  
Skeletal Muscle ◽  
Dietary Intake ◽  
The Elderly ◽  
Food Group ◽  
Cross Sectional Study ◽  
Nutrition Survey ◽  
Cross Sectional ◽  
Ageing Society ◽  
Skeletal Muscle Index ◽  
Japanese Elderly

AbstractObjective:To examine nutrient and food intakes according to the levels of skeletal muscle mass index (SMI) in the elderly.Design:Cross-sectional study.Setting:Data were derived from the 2017 National Health and Nutrition Survey in Japan. SMI was calculated by dividing appendicular skeletal muscle (or lean) mass (kg) by height squared (m2). We calculated the multivariable-adjusted means of individuals’ dietary intake. Dietary intake of energy, nutrients and food categories was assessed by examining dietary records using a semi-weighed method and compared according to the sex-specific quartiles of SMI.Participants:Men and women aged ≥60 years.Results:Among 797 men and 969 women, individuals with a higher SMI consumed more energy and more nutrients than did those with a lower SMI after adjusting for age, lifestyle and physical activity factors. After further adjusting for energy intake, total dietary fibre, vitamin A, vitamin B6, K, Fe and Cu were positively associated with higher SMI in men (Pfor trend < 0·05). For food categories, men with a higher SMI consumed more vegetables and meats, but the associations were attenuated after adjustment for energy and remained significant for vegetable only (Pfor trend = 0·018).Conclusions:Japanese elderly people with a higher SMI consumed more energy and nutrients and more vegetables than did those with a lower SMI. This finding shows that diet is important in preventing muscle loss among the elderly in an ageing society.

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