Change of skeletal muscle index during the chemotherapy as a prognostic factor of survival in pancreatic cancer patients receiving palliative chemotherapy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 363-363
Author(s):  
Younak Choi ◽  
Tae Yong Kim ◽  
Kyung-Hun Lee ◽  
Sae-Won Han ◽  
Do-Youn Oh ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Palliative Chemotherapy ◽  
Cross Sectional ◽  
Poor Prognostic Factor ◽  
Skeletal Muscle Index ◽  
Korean People ◽  
Muscle Cross Sectional Area

363 Background: Body composition has emerged as a prognostic factor in cancer patients. We investigated whether sarcopenia at the diagnosis and progressive loss of skeletal muscle were associated with survival in pancreatic cancer (PC) patients receiving palliative chemotherapy. Methods: We retrospectively reviewed PC patients receiving palliative chemotherapy between 2003 and 2010. Skeletal muscle cross-sectional area at L3 was measured by computed tomography. Sarcopenia was defined using the previously published sex-specific cutoff points for Korean people. Loss of skeletal muscle was classified by sex-specific cutoffs from ROC curve. Results: Among 484 patients, 260 (53.7%) patients were more than sixty years old and 295 (61.0%) patients were male. Overall, 187 (38.6%) patients were sarcopenic at the diagnosis (male, <49.2cm2/m2; female, <31.1 cm2/m2). Decreased skeletal muscle index (SMI) during the chemotherapy, which was defined as a reduction by more than 0.21 for male and by more than 2.19 for female, was observed in 198 (77.3%) male patients and 61 (38.1%) female patients. Decreased body mass index (BMI) by more than 1 was observed in 149 patients (37.3%) without difference between genders. Median overall survival (OS) of whole patients was 8.4 months [95%CI 7.6-9.2]. In the multivariate analysis, sarcopenia (p=0.001), decreased SMI (p=0.003), and decreased BMI (p=0.001) was significantly poor prognostic factors for OS. When we analyzed four groups by SMI and BMI changes (maintained SMI and BMI, maintained SMI and decreased BMI, decreased SMI and maintained BMI, decreased SMI and BMI), the groups with maintained SMI had longer survival than the groups with decreased SMI regardless of BMI changes. Median OS was 11.5 months with maintained SMI and 8.1 months with decreased SMI (HR 0.534 and 1, p=0.004) in decreased BMI groups and 9.9 months with maintained SMI and 8.6 months with decreased SMI (HR 1 and 1.490, p=0.002) in maintained BMI groups, respectively. The analyses separately done by gender showed similar results. Conclusions: Decrease of SMI during chemotherapy was a significantly poor prognostic factor for survival regardless of BMI changes.

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 Depletion of Pre-Transplant Skeletal Muscle Is a Significant Poor Prognostic Factor in Allogeneic Hematopoietic Cell Transplantation

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3322-3322
Author(s):  
Yasuhiko Shibasaki ◽  
Kenta Kobayashi ◽  
Tatsuya Suwabe ◽  
Kyoko Fuse ◽  
Miwako Narita ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Hematological Disease ◽  
Cross Sectional ◽  
Poor Prognostic Factor ◽  
Muscle Cross Sectional Area ◽  
Total Muscle

Introduction Depletion of skeletal muscle is a poor prognostic factor for patients with various malignancies; however its significance for allogeneic hematopoietic cell transplantation (allo-HCT) in patients with hematological disease is unclear. Generally, muscle mass is measured by the methods established by the European Working Group on Sarcopenia in Older People, which require the use of dual energy X-ray absorptiometry or bioimpedance analysis, methods that are not performed in routine practice. Therefore, cross-sectional imaging using computed tomography (CT) has been suggested as an alternative method for analyzing muscle mass in clinical practice. Especially, lumbar total muscle cross-sectional area using CT, normalized for body height, which was named lumbar skeletal muscle mass index (SMI), is reported as an indicator of nutritional status, sarcopenia and cancer cachexia in patients with solid organ malignancy. Aims To clarify the usefulness of a pre-transplant lumber SMI as a prognostic indicator for allo-HCT patients. Methods Among 208 patients with hematological disease who underwent allo-HCT between 2006 and 2017 at our facility, 191 patients (95 males and 96 females) underwent CT scans for routine pre-transplant status assessment. Ninety patients had acute myeloid leukemia, 38 patients had acute lymphoblastic leukemia, 24 patients had myelodysplastic syndrome, 20 patients had malignant lymphoma, and 19 patients had other diseases. The median age of the patients was 42 years old (range: 16-66 years). Seventy-eight patients received myeloablative conditioning and the others received reduced intensity conditioning regimens. The number of patients in each HCT-comorbidity index (HCT-CI) risk group was as follows: low: 72, intermediate: 54 and high: 65. Axial images at the iliac crest were selected for analysis of lumber total muscle cross-sectional area (cm2). The rectus abdominus, psoas and paraspinal muscles were identified and quantified. Lumbar total muscle cross-sectional area was normalized for body height in meters squared (m2) and used to calculate lumbar SMI (cm2/m2). This study was performed in accordance with the Japanese Ethical Guidelines for Medical and Health Research Involving Humans and approved by the Ethical Committee of our facility. Results The median pre-transplant lumber SMI of the male patients was significantly higher than that of the female patients (42.7 (24.9-60.2) mm2/m2 vs. 31.9 (20.7-44.6) mm2/m2, p<0.01). We defined the cutoff value of lumber SMI as 42.7cm2/m2 for male and 31.9cm2/m2 for female patients. In the Kaplan-Meier estimate analysis, low lumber SMI was a significant poor prognostic factor for overall survival (p=0.016). In multivariate analysis using Cox regression model, adjusting for age, refined disease risk index, conditioning and HCT-CI, low lumber SMI was extracted as a significant poor prognostic factor for overall survival (hazard ratio 1.56, 95% confidence interval (CI) 1.03-2.36, p=0.036). By logistic regression analysis, adjusted odds ratio of 1-year non-relapse mortality for low lumber SMI was 2.47 (95% CI 1.13-5.41, p=0.024). Conclusion Low pre-transplant lumber SMI is a significant poor prognostic factor in allo-HCT, independent of other risk factors including HCT-CI and refined disease risk index in patients with hematological disease. It is affected by the high rate of non-relapse mortality in the early phase following allo-HCT in patients with low lumber SMI. Disclosures No relevant conflicts of interest to declare.

Maintenance of Skeletal Muscle Mass During FOLFIRINOX is a Favorable Prognostic Factor in Pancreatic Cancer Patients

2021 ◽  
Author(s):  
Dong Woo Shin ◽  
Minseok Albert Kim ◽  
Jong-chan Lee ◽  
Jaihwan Kim ◽  
Jin-Hyeok Hwang
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Clinical Outcomes ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Lumbar Vertebra ◽  
Resection Rate ◽  
Cross Sectional ◽  
Group 2

Abstract Objective: The study aimed to investigate the effect of body composition changes during chemotherapy on clinical outcomes in patients with pancreatic cancer.Results: In patients with locally advanced pancreatic cancer (LAPC), the cross-sectional area of skeletal muscle (SM) and adipose tissue (AT) at the level of third lumbar vertebra was measured. The SM and AT ratios indicated the changes during chemotherapy. The patients were classified into three groups based on these ratios: group 1, ≥1.00; group 2, 0.85-0.99; group 3, <0.85. The overall survival (OS) and surgical resection rates were estimated. Fifty-eight patients with LAPC who received first-line FOLFIRINOX were analysed. Fifteen (25.9%) patients who underwent resection showed maintained BMI, SM, and AT as compared to the patients who did not undergo resection. As the SM ratio decreased, the risk for death increased significantly. Further, the resection rate was significantly higher in patients with maintained SM compared to those with low SM ratio. On the contrary, the change in AT ratio was not associated with OS and resection rate; however, significant decrease in AT more than 15% showed poor clinical outcomes. Maintenance of SM during chemotherapy is a reliable prognostic factor indicating longer OS and higher resection rate.

Pretreatment skeletal muscle depletion as an adverse prognostic factor in metastatic gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 161-161
Author(s):  
Hiroko Hasegawa ◽  
Kazumasa Fujitani ◽  
Yusuke Yamaoka ◽  
Motohiro Hirao ◽  
Shoichi Nakazuru ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Performance Status ◽  
Metastatic Gastric Cancer ◽  
First Line ◽  
Skeletal Muscle Index ◽  
Pre Treatment ◽  
The Impact

161 Background: Body composition has emerged as an important prognostic factor in cancer patients. Especially, skeletal mass depletion has been associated with poor performance status, toxicity of chemotherapy and shortened survival in cancer patients. However, the impact of pre-treatment skeletal muscle index on survival or toxicity in metastatic gastric cancer patients remains uncertain. Methods: In this retrospective study, we reviewed 98 metastatic gastric cancer (mGC) patients who received S-1 based combination chemotherapy as first-line treatment from April 2006 to March 2013. Pre-treatment skeletal muscle mass was quantified by CT cross sectional area at the third lumbar vertebrae and evaluated as lumbar skeletal muscle index (SMI) (cm2/m2) after normalization for stature (m2). Patients were categorized into 2 groups depending on initial SMI: 35 patients with SMI ≤ 40 and 63 patients with SMI > 40. Results: Median overall survival was significantly shorter in the SMI ≤ 40 group than in the SMI >40 group (439 days versus 565 days; p= 0.03). Progression free survival was also better in the SMI> 40 group without statistical significance (175 days versus 151 days; p= 0.17). Toxicity (grade 3 or 4) was more common in the SMI ≤ 40 group than in the SMI >40 group. (41.1% versus 11.1%; p=0.001). In multivariate analysis, performance status of 2 (HR 4.711, 95%CI 1.065 to 20.832, p=0.04), presence of primary tumor (HR 2.322, 95%CI 1.007 to 5.357, p=0.04) and pre-treatment SMI (HR 2.525, 95%CI 1.145 to 5.568, p=0.02) were independent prognostic factors for OS. Conclusions: The present study suggests that skeletal muscle depletion at the initiation of first-line chemotherapy might be an independent prognostic factor for mGC patients.

Myopenia as a significant prognostic factor in BCLC-B intermediate-stage hepatocellular carcinoma treated with sorafenib.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15639-e15639
Author(s):  
Mao Okada ◽  
Hiroyuki Nakanishi ◽  
Masayuki Kurosaki ◽  
Sakura Kirino ◽  
Leona Osawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Skeletal Muscle ◽  
Prognostic Factor ◽  
Kinase Inhibitors ◽  
Treatment Options ◽  
Intermediate Stage ◽  
Significant Prognostic Factor ◽  
Poor Prognostic Factor ◽  
Skeletal Muscle Index ◽  
The Impact

e15639 Background: Tyrosine kinase inhibitors (TKI) are important treatment options for unresectable hepatocellular carcinoma (HCC). The survival benefit of sorafernib was demonstrated not only in advanced stage but also for BCLC-B intermediate stage who are refractory to transcatheter arterial chemoembolization by OPTIMIS study. Skeletal muscle mass depletion (Myopenia) is a poor prognostic factor in HCC treated by resection or loco-reginal ablation, but its effect on survival in TKI treated patients, especially in those within BCLC-B stage remains unclear. The aim of the present study is to elucidate the impact of myopenia on survival among HCC treated with sorafenib, especially in BCLC-B stage. Methods: In 213 patients who started treatment with sorafenib between 2009 and 2016, myopenia at baseline was determined by using skeletal muscle index calculated from CT images of the third lumber vertebra level. The impact of myopenia on survival was analyzed in whole patients, after stratification by BCLC stage, and after matching for backgrounds within BCLC-B patients. Results: The median survival in whole, BCLC-C, and –B was 13.7, 8.7 and 15.2 months, respectively. Myopenia was not a significant prognostic factor in whole patients and in BCLC-C stage. However, among BCLC-B patients (n = 104), survival was significantly better in patients with no myopenia (p = 0.05). Among them, 85 patients who continued sorafenib for more than 8 weeks were extracted and those with or without myopenia were matched for backgrounds by propensity score. Backgrounds including etiology, Child-Pugh score, BMI, AFP and PIVKA-Ⅱwas not different between myopenia (n = 30) and no myopenia group (n = 30) after matching. The overall survival at 6-, 12-, and 24-months was 96%, 74%, and 62% in no myopenia group which was significantly better compared to 89%, 64%, and 28% in myopenia group (p = 0.019). The hazard ratio was 2.12 (95% CI 1.11-4.03). Conclusions: Absence of myopenia predicts favorable outcome in sorafenib treated HCC patients within BCLC-B intermediate stage.

scholarly journals Sarcopenic Factors May Have No Impact on Outcomes in Ovarian Cancer Patients

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 206 ◽  
Author(s):  
Naomi Nakayama ◽  
Kentaro Nakayama ◽  
Kohei Nakamura ◽  
Sultana Razia ◽  
Satoru Kyo
Keyword(s):  
Ovarian Cancer ◽  
Skeletal Muscle ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Muscle Volume ◽  
Muscle Quality ◽  
Prognostic Impact ◽  
Poor Prognostic Factor ◽  
Skeletal Muscle Index ◽  
The Impact

Although the prognostic value of sarcopenic factors, such as loss of muscle mass and quality, have been widely reported in patients with cancer during the last decade, the value in those with ovarian cancer remains unclear. Therefore, this study evaluated the prognostic impact of sarcopenic factors in patients with ovarian cancer. We retrospectively evaluated the data of 94 ovarian cancer patients who underwent surgery and chemotherapy at the Shimane University Hospital between March 2006 and 2013. Preoperative computed tomography scan at the level of the third lumbar vertebra was used to evaluate skeletal muscle volume and quality based on the skeletal muscle index (SMI) and intramuscular adipose tissue content (IMAC), respectively. The impact of preoperative SMI and IMAC on outcomes was subsequently investigated. Low SMI and high IMAC were not significantly associated with disease-free survival (p = 0.329 and p = 0.3370, respectively) or poor overall survival (p = 0.921 and p = 0.988, respectively). Neither preoperative low muscle volume nor low muscle quality was a poor prognostic factor in ovarian cancer.

scholarly journals Maintenance of skeletal muscle mass during FOLFIRINOX is a favorable prognostic factor in pancreatic cancer patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Dong Woo Shin ◽  
Minseok Albert Kim ◽  
Jong-chan Lee ◽  
Jaihwan Kim ◽  
Jin-Hyeok Hwang
Keyword(s):  
Skeletal Muscle ◽  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Clinical Outcomes ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Lumbar Vertebra ◽  
Resection Rate ◽  
Cross Sectional ◽  
Group 2

Abstract Objective The study aimed to investigate the effect of body composition changes during chemotherapy on clinical outcomes in patients with pancreatic cancer. Results In patients with locally advanced pancreatic cancer (LAPC), the cross-sectional area of skeletal muscle (SM) and adipose tissue (AT) at the level of third lumbar vertebra was measured. The SM and AT ratios indicated the changes during chemotherapy. The patients were classified into three groups based on these ratios: group 1, ≥ 1.00; group 2, 0.85–0.99; group 3, < 0.85. The overall survival (OS) and surgical resection rates were estimated. Fifty-eight patients with LAPC who received first-line FOLFIRINOX were analyzed. Fifteen (25.9%) patients who underwent resection showed maintained BMI, SM, and AT as compared to the patients who did not undergo resection. As the SM ratio decreased, the risk for death increased significantly. Further, the resection rate was significantly higher in patients with maintained SM compared to those with low SM ratio. On the contrary, the change in AT ratio was not associated with OS and resection rate; however, significant decrease in AT more than 15% showed poor clinical outcomes. Maintenance of SM during chemotherapy is a reliable prognostic factor indicating longer OS and higher resection rate.

High C-reactive protein (CRP) level and leukocytosis as a prognostic factor for metastatic pancreatic cancer (MPC) patients with good performance status.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14677-e14677
Author(s):  
Masato Ozaka ◽  
Hiroshi Ishii ◽  
Seigo Yukisawa
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Selection Criteria ◽  
Performance Status ◽  
Metastatic Pancreatic Cancer ◽  
Poor Overall Survival ◽  
Poor Prognostic Factor ◽  
Good Performance Status

e14677 Background: Prognostic factor for metastatic pancreatic cancer patients (pts) with good performance status has not been fully evaluated. The objective is to investigate the prognostic factor for metastatic pancreatic cancer patients with good performance status. Methods: Data was collected from the medical records of patients at our hospital. The selection criteria were as follows: 1) histologically proven MPC, 2) ECOG performance status 0 or 1, 3) inoperable or recurrent metastatic disease treated with systemic chemotherapy between Sep. 2007 and June 2011. Results: There were 123 pts who met selection criteria in this study. The median age was 65 years (range, 41-86); male/female, 70/53 pts; the metastatic site was liver/peritoneum/lung/lymph nodes/others in 75/31/15/10/ pts. Median overall survival was 9.5 months, respectively. Of the 123, 11 pts showed leukocytosis (WBC>10000) and 19 pts showed High CRP level (CRP>2.0). Pts with leukocytosis and high CRP level showed significantly poor overall survival (4.44 and 4.44 months). A multivariate analysis demonstrated that a leukocytosis and high CRP level were independent unfavorable prognostic factors. Conclusions: High CRP level and leukocytosis may be a poor prognostic factor for MPC patients with good performance status.

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