scholarly journals Association between Skeletal Muscle Loss and the Response to Neoadjuvant Chemotherapy for Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1806
Author(s):  
Byung Min Lee ◽  
Yeona Cho ◽  
Jun Won Kim ◽  
Sung Gwe Ahn ◽  
Jee Hung Kim ◽  
...  

There are no means to predict patient response to neoadjuvant chemotherapy (NAC); the impact of skeletal muscle loss on the response to NAC remains undefined. We investigated the association between response to chemotherapy and skeletal muscle loss in breast cancer patients. Patients diagnosed with invasive breast cancer who were treated with NAC, surgery, and radiotherapy were analyzed. We quantified skeletal muscle loss using pre-NAC and post-NAC computed tomography scans. The response to treatment was determined using the Response Evaluation Criteria in Solid Tumors. We included 246 patients in this study (median follow-up, 28.85 months). The median age was 48 years old (interquartile range 42–54) and 115 patients were less than 48 years old (46.7%). Patients showing a complete or partial response were categorized into the responder group (208 patients); the rest were categorized into the non-responder group (38 patients). The skeletal muscle mass cut-off value was determined using a receiver operating characteristic curve; it showed areas under the curve of 0.732 and 0.885 for the pre-NAC and post-NAC skeletal muscle index (p < 0.001 for both), respectively. Skeletal muscle loss and cancer stage were significantly associated with poor response to NAC in locally advanced breast cancer patients. Accurately measuring muscle loss to guide treatment and delaying muscle loss through various interventions would help enhance the response to NAC and improve clinical outcomes.

2017 ◽  
Vol 25 (7) ◽  
pp. 2221-2227 ◽  
Author(s):  
Yoshiko Kubo ◽  
Tateaki Naito ◽  
Keita Mori ◽  
Gakuji Osawa ◽  
Etsuko Aruga

2008 ◽  
Vol 26 (25) ◽  
pp. 4072-4077 ◽  
Author(s):  
Jennifer K. Litton ◽  
Ana M. Gonzalez-Angulo ◽  
Carla L. Warneke ◽  
Aman U. Buzdar ◽  
Shu-Wan Kau ◽  
...  

Purpose To understand the mechanism through which obesity in breast cancer patients is associated with poorer outcome, we evaluated body mass index (BMI) and response to neoadjuvant chemotherapy (NC) in women with operable breast cancer. Patients and Methods From May 1990 to July 2004, 1,169 patients were diagnosed with invasive breast cancer at M. D. Anderson Cancer Center and received NC before surgery. Patients were categorized as obese (BMI ≥ 30 kg/m2), overweight (BMI of 25 to < 30 kg/m2), or normal/underweight (BMI < 25 kg/m2). Logistic regression was used to examine associations between BMI and pathologic complete response (pCR). Breast cancer–specific, progression-free, and overall survival times were examined using the Kaplan-Meier method and Cox proportional hazards regression analysis. All statistical tests were two-sided. Results Median age was 50 years; 30% of patients were obese, 32% were overweight, and 38% were normal or underweight. In multivariate analysis, there was no significant difference in pCR for obese compared with normal weight patients (odds ratio [OR] = 0.78; 95% CI, 0.49 to 1.26). Overweight and the combination of overweight and obese patients were significantly less likely to have a pCR (OR = 0.59; 95% CI, 0.37 to 0.95; and OR = 0.67; 95% CI, 0.45 to 0.99, respectively). Obese patients were more likely to have hormone-negative tumors (P < .01), stage III tumors (P < .01), and worse overall survival (P = .006) at a median follow-up time of 4.1 years. Conclusion Higher BMI was associated with worse pCR to NC. In addition, its association with worse overall survival suggests that greater attention should be focused on this risk factor to optimize the care of breast cancer patients.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Cong Jiang ◽  
Yubo Lu ◽  
Shiyuan Zhang ◽  
Yuanxi Huang

Background and Methods. As a parameter integrating neutrophil (N), lymphocyte (L), and platelet (P) levels, altered systemic immune-inflammation index (SII) has been investigated in a number of malignant tumor types. Here, we explore the impact of SII in a cohort of 249 breast cancer patients receiving neoadjuvant chemotherapy (NAC), investigating the prognostic value of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). All patients had complete follow-up data and pathological confirmation of breast cancer by a core needle biopsy prior to NAC treatment and surgery. All blood samples were obtained within one week prior to NAC. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value for patient classification by SII, NLR, and PLR. Associations between clinicopathological variables by SII, NLR, and PLR were determined by a chi-squared test or Fisher’s exact test. Overall survival (OS) analysis was performed using Kaplan-Meier plots, log-rank tests, and Cox proportional hazards regression models. The Z test is used to compare the prognostic ability of SII, NLR, and PLR. Results. SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017 , HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant ( Z = 2.721 , 95% CI: 0.0194-0.119, P = 0.0065 ). Conclusion. Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.


The Breast ◽  
2018 ◽  
Vol 39 ◽  
pp. 19-23 ◽  
Author(s):  
Annina Baumgartner ◽  
Christoph Tausch ◽  
Stefanie Hosch ◽  
Bärbel Papassotiropoulos ◽  
Zsuzsanna Varga ◽  
...  

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