BackgroundThe prognostic value of body composition in cancer patients has been widely studied during the last decade. The main finding of these studies is that sarcopenia, or skeletal muscle depletion, assessed by CT imaging correlates with a reduced overall survival (OS). By contrast, the prognostic value of fat mass remains ill-defined. This study aims to analyze the influence of body composition including both muscle mass and adipose tissue on OS in a homogeneous population of advanced colorectal cancer (CRC) patients.MethodsAmong 235 patients with chemorefractory advanced CRC included in the SoMore and RegARd-C trials, body composition was assessed in 217 patients on baseline CT images. The relationship between body composition (sarcopenia, muscle density, subcutaneous and visceral fat index and density), body mass index (BMI) and OS were evaluated.ResultsPatients with a higher BMI had a better OS (≥30 versus < 30, HR: 0.50; 0.33–0.76). Those with low muscle index and muscle density had an increased mortality (HR: 2.06; 1.45–2.93 and HR: 1.54; 1.09–2.18, respectively). Likewise, low subcutaneous and visceral fat index were associated with an increased risk of dying (HR: 1.63; 1.23–2.17 and 1.48; 1.09–2.02 respectively), as were a high subcutaneous and visceral adipose tissue density (HR: 1.93; 1.44–2.57 and 2.40; 1.79–3.20 respectively). In multivariate analysis, a high visceral fat density was the main predictor of poor survival.ConclusionsOur results confirm the protective role of obesity in CRC patients at an advanced stage, as well as the negative prognostic impact of muscle depletion on survival. More importantly, our data show for the first time that visceral adipose tissue density is an important prognostic factor in metastatic CRC.Trial registrationNCT01290926, 07/02/2011 and NCT01929616, 28/08/2013.
Normal kidneys were studied echographically in 170 children from 0-15 years of age. The length, thickness, width, volume and largest sagittal and transverse areas were measured and plotted against the children's height and body surface to establish standard growth curves. The usefulness of this non-invasive inter- and intra-individual estimation of renal size in following the progress of kidney alteration in children was illustrated in one case of malakoplakia and one case of parenchymal scars.
Goals: an evaluation of effectiveness of Fludarabine, Cyclophosphomide and Rituximab (FCR therapy) for patients with newly diagnosed Chronic Lymphocytic Leukemia (CLL) for validation of results from multi-centered clinical trials in real clinical practice. Materials and methods: sixty six (66) patients with newly diagnosis of CLL were included to this prospective study with average age of 58 years old (39-73 years old). Stage I -II according to Rai staging system was found in 76% of patients; Stage III-IV -in 24 % of patients. All patients received 6-8 cycles of inductive FCR therapy: Rituximab 375 mg/m 2, iv -first cycle, followed by 500 mg/m 2, iv; Fludarabine -25 mg/m 2, iv -days 2,3 and 4 of a cycle; Cyclophosphamide -250 mg/m 2 ,iv-days 2,3 and 4 of a cycle). Patients were divided into two groups based on duration of induction cycles (IC). Group 1 had average IC of 36 days; Group 2 -49 days. Evaluation of immunochemotherapy effectiveness was determined by presence of remissions (IWCLL-2008), progression-free survival (PFS) and overall survival (OS) (Kaplan -Meier method).Results: Complete Remission (CR) was observed more often in Group 1 (FCR-36) than in Group 2 (FCR-49) -56.6% and 37.9% of patients, respectively (p > 0.05). Median PFS was 36 months in all patients; 45 months -in Group 1 (FCR-36) and was not achieved in Group 2 (FCR-49). Median OS was 45 months in Group 1 (FCR-36) and was not achieved in Group 2 (FCR-49).Conclusions: confirmation of FCR therapy effectiveness for newly diagnosed CLL patients was established in real clinical practice characterized by non-selective patient groups and prolonged induction therapy cycles. Results of this study provide validation for results from multi-centered clinical trials and could be reproduced on a greater scale in clinical practice.
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