Sarcopenia in bladder cancer patients is an unmodifiable outcomes predictor.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 480-480
Author(s):  
Gregory John Barton ◽  
Jeanette Wang ◽  
Andrew Chang ◽  
Wei Phin Tan ◽  
Joseph J Fantony ◽  
...  
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Bladder Cancer ◽  
Muscle Mass ◽  
Healthy Eating Index ◽  
Activity Level ◽  
Lifestyle Interventions ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Diet And Physical Activity

480 Background: Sarcopenia, a severe loss of skeletal muscle mass, predicts poor outcomes in bladder cancer (BC). But, why sarcopenia occurs in BC is unknown. Our objective was to assess if diet and physical activity were the primary factors causing sarcopenia, and thus assess if sarcopenia could be addressed by lifestyle interventions. Methods: 286 patients filled out the International Physical Activity Questionnaire Long Form (IPAQ-L) and the Diet History Questionnaire II (DHQ2), had a CT abdomen/pelvis within 6 months of questionnaire administration and met inclusion criteria. The DHQ2 was converted into Healthy Eating Index 2010 scores (HEI2010). Skeletal muscle area (SM, cm2) area was measured at the L3 level using Slice-O-Matic software and divided by height (m2) to arrive at skeletal muscle index (SMI). Sarcopenia was defined as SMI < 52.4 in men and < 38.5 in women. Three raters read the images and inter-rater reliability was measured by the intra-class correlation coefficient (ICC). Associations among patient demographics, tumor characteristics, physical activity, diet quality, and body composition were examined by stratified analyses and regression models with R 3.2.3. Results: Reliability was very high, ICC=0.97. Sarcopenia was present in 71% of males and 55% of females. Key predictors of decreasing SMI included increasing age (p < 0.001), female gender (p < 0.001), and white race (p < 0.001). When adjusted for these unmodifiable patient factors, there was no association between SMI and variables such as Elixhauser comorbidity score, AJCC stage, tumor grade, and procedure type. With respect to modifiable lifestyle factors, there was no association between SMI and average weekly MET-min of physical activity level (p = 0.99) nor the daily consumption of calories (p = 0.69), protein (p = 0.28), fat (p = 0.19), or carbohydrate (p = 0.77). The HEI2010 diet score was not associated with SMI (p = 0.66). Conclusions: The three strongest predictors of decreasing muscle mass (i.e. sarcopenia) in BC patients are age, gender, and race. Modifiable risk factors, such as diet and physical activity levels, did not affect sarcopenia. Therefore, we would not expect that targeted lifestyle interventions would affect sarcopenia and improve BC outcomes.

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 Association between CT-Measured Abdominal Skeletal Muscle Mass and Pulmonary Function

2019 ◽  
Vol 8 (5) ◽  
pp. 667 ◽  
Author(s):  
Eun Kyung Choe ◽  
Young Lee ◽  
Hae Yeon Kang ◽  
Seung Ho Choi ◽  
Joo Sung Kim
Keyword(s):  
Skeletal Muscle ◽  
Lung Function ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lumbar Vertebrae ◽  
Forced Expiratory Volume ◽  
The Body ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Clinical Records

A relationship between lung function and sarcopenia has been suggested. This study aimed to evaluate the association between lung function and abdominal skeletal muscle mass, as measured by computed tomography (CT). The clinical records of 1907 subjects (1406 males, mean age 53.1 ± 9.2 years), who underwent routine health check-ups, including spirometry and abdominal CT, were retrospectively reviewed. The CT-measured skeletal muscle index (SMICT, cm2/(kg/m2) was defined as the skeletal muscle area of the third lumbar vertebrae (L3) level that is normalized by the body mass index. The mean values of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) gradually increased as the SMICT quartiles increased (all p for trend < 0.05). The proportions of subjects with less than 80% of the predicted FVC (%) and predicted FEV1 (%) significantly decreased as the SMICT quartiles increased (all p for trend < 0.05). The β regression coefficients for FVC and FEV1 significantly increased as the SMICT quartiles increased after adjusting for other confounding variables (p for trend < 0.05). This study showed that abdominal muscle mass, which was precisely measured by CT, independently affected lung function proportionally after adjusting for confounding factors in relatively healthy adults.

scholarly journals Sarcopenia and Predictors of Skeletal Muscle Mass in Elderly Men With and Without Obesity

2017 ◽  
Vol 3 ◽  
pp. 233372141771363 ◽  
Author(s):  
Katja Stoever ◽  
Anke Heber ◽  
Sabine Eichberg ◽  
Klara Brixius
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Gait Speed ◽  
Strong Correlations ◽  
Elderly Men ◽  
Skeletal Muscle Index ◽  
European Working ◽  
Upper And Lower Extremities ◽  
Definition Of

Objectives: The aim of this study was to determine the variables which show the highest association with muscle mass and to identify the most important predictors for muscle mass in elderly men with and without sarcopenia. Methods: A total of 71 men participated, aged ≥65 years. Sarcopenia was assessed using the definition of the European Working Group on Sarcopenia in Older People with determining skeletal muscle index (SMI), hand-grip strength (HGS), and Short Physical Performance Battery. In addition, maximum strength at upper and lower extremities and physical activity were measured. Results: Strong correlations existed between SMI and gait speed, HGS, maximum isometric strength at leg and chest press. Physical activity showed low correlations with muscle strength. Regression analysis revealed HGS and gait speed as key predictors for SMI. Discussion: The recommendation is measuring gait speed and HGS in clinical practice at first followed by measuring muscle mass for determining sarcopenia.

Association of muscle mass with pathologic response and toxicity in localized bladder cancer patients treated by neoadjuvant chemotherapy (NAC) and radical cystectomy (RC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16022-e16022
Author(s):  
Charlotte Fenioux ◽  
Olivier Huillard ◽  
Evanguelos Xylinas ◽  
Camille Tlemsani ◽  
Pascaline Boudou-Rouquette ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Bladder Cancer ◽  
Ct Scan ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Lumbar Vertebra ◽  
Pathologic Response ◽  
Pathological Response ◽  
Severe Toxicity ◽  
Skeletal Muscle Index

e16022 Background: Sarcopenia, the condition of low muscle mass, is a prognostic factor across many cancer types including bladder cancer. Moreover, sarcopenia was shown to predict severe toxicity induced by many anticancer agents. Conversely, NAC may increase the prevalence of sarcopenia before surgery. This retrospective study aimed to investigate the association of sarcopenia with pathologic response and toxicity in localized bladder cancer patients treated by NAC and RC. Methods: Among the 52 patients who underwent RC after NAC between Jan 2010 and Dec 2016, the preoperative sarcopenia status could be determined for 39 patients. Skeletal muscle cross-sectional area at the third lumbar vertebra was measured on CT scan images, and sarcopenia was defined as skeletal muscle index of < 43 cm2/m2 for men with body mass index (BMI) < 25 kg/m2, SMI < 53 cm2/m2 for men with BMI > 25 kg/m2, and SMI < 41 cm2/m2 for women. The criteria for efficacy was pathologic response defined by pathological down-staging to ≤ pT1N0. Patients were compared using χ2 or Fischer’s exact test when appropriate. Results: 48% of patients were sarcopenic before RC. A significant higher rate of pathological response was found in non-sarcopenic patients compared to sarcopenic patients (13/20 vs 5/19, P = 0.01). More severe chemotherapy related toxicity was found in sarcopenic patients compared to non-sarcopenic patients for neutropenia (P = 0.06), thrombopenia (P = 0.15), and neuropathy (P = 0.23). Among the 21 patients for whom sarcopenia status before chemotherapy was available, 3 patients became sarcopenic and 4 patients initially sarcopenic gained muscle mass on post-chemotherapy CT scan. Conclusions: Sarcopenia is frequent in localized bladder cancer patients. Muscle mass correlates with pathological response to NAC.

scholarly journals Characterizing Muscle Phenotype and Prognosis in Patients with Multiple Myeloma

2020 ◽  
Vol 3 ◽  
Author(s):  
Shannon Zhou ◽  
Libbie Silverman ◽  
Andrew Young ◽  
David Roodman ◽  
Attaya Suvannasankha ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Multiple Myeloma ◽  
Muscle Mass ◽  
Lumbar Vertebrae ◽  
University Hospital ◽  
Muscle Quality ◽  
Rank Test ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Skeletal Muscle Area

Background/Objective:  Low muscle mass (myopenia), poor muscle quality, myosteatosis, and muscle loss are associated with mortality in solid tumors. However, their impact in hematological malignancies remains unclear. We sought to determine how muscle phenotype relates to survival in patients with multiple myeloma.  Methods:  We performed a retrospective review of patients with multiple myeloma treated at Indiana University Hospital from 2012-2016. Total skeletal muscle area (SMA) (cm2) and radiodensity were measured on baseline (closest to diagnosis) and last CT scans at the third lumbar vertebrae area. SMA was normalized to height (SMA cm2/m2) to define skeletal muscle index (SKMI). Myopenia was defined as (SKMI) <52.4 cm2/m2 (men) and <38.5 cm2/m2 (women). Myosteatosis and obesity were defined per published BMI-specific cutoffs. Difference in survival between groups was estimated using log rank test.   Results:  Of 455 patients with multiple myeloma, 137 had more than one CT scan; 42 of these have been assessed to date. Half (21/42) were myopenic. Myopenia was equally prevalent across BMI categories and showed no association with survival. More than half of patients displayed myostetatosis; however, this was not associated with survival.  Obesity and myopenic obesity were likewise not correlated with survival. Below-median baseline SKMI correlated with mortality, HR 2.721 (95% CI, 1.160-5.564: P=0.0129). As well, below-median final SMA correlated with mortality, HR 2.381 (95% CI, 1.094-5.181, P=0.0213). On average patients lost .7129% of SMA (95% CI; -6.072%-4.646%). Females had higher mortality, HR 2.355 (95% CI 0.9895-5.604, P=0.0215).   Conclusion and Potential Impact:  Although this study represents a fraction of treated patients to date, myopenia was prevalent among patients at diagnosis of multiple myeloma. Low muscle mass and sex appear to be important prognostic factors for survival. Additional measurements as well as univariate and multivariate analyses are necessary to verify these findings and identify additional factors that contribute to survival in multiple myeloma. 

Change in skeletal muscle index and its prognostic significance in conversion therapy for initially unresectable colorectal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 56-56
Author(s):  
Hiroaki Nozawa ◽  
Shigenobu Emoto ◽  
Koji Murono ◽  
Yasutaka Shuno ◽  
Soichiro Ishihara
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscles ◽  
Systemic Chemotherapy ◽  
Stage Iv ◽  
The Body ◽  
Pharmacological Intervention ◽  
Conversion Therapy ◽  
Skeletal Muscle Index

56 Background: Systemic chemotherapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is largely 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 chemotherapy 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 chemotherapy 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 chemotherapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the Conversion group. Results: The mean SMI increased by 8.0% during chemotherapy in the Conversion group (n = 38), whereas it decreased by 6.2% in the NAC group (n = 18) and 3.7% in the Palliation group (n = 42, p < 0.0001). Moreover, patients with increased SMI during chemotherapy had a better overall survival (OS) than those whose SMI decreased in the Conversion group (p = 0.021). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio: 0.26). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. As such an increase in SMI further conveys a survival benefit in conversion therapy, it may be important to make efforts to preserve muscle mass by meticulous approaches, such as nutritional support, muscle exercise programs, and pharmacological intervention even during chemotherapy in patients with metastatic CRC.

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