Low skeletal muscle mass as a proxy parameter for sarcopenia acts as a non-invasive imaging marker that is associated with poor prognosis in numerous types of cancer. The present study aimed to assess the influence of body composition parameters on overall survival (OS) and progression free survival (PFS) in patients diagnosed with primary central nervous system lymphoma (PCNSL). A total of 98 patients with PCNSL treated at University Hospital Magdeburg (Magdeburg, Germany) from 2013-2019 were retrospectively studied. Patients with a pre-treatment staging computed tomography (CT) scan that included the third lumbar vertebra were reviewed for analysis. Skeletal muscle area (SMA), skeletal muscle index (SMI), mean muscle density and skeletal muscle gauge (SMG) were measured on the CT scan prior to treatment. Parameters were associated with OS and PFS. Overall, 72 patients were included in the present study. Results of the present study demonstrated that the median OS was 10 months (range, 1-181 months), and 37 patients (51.4%) presented with sarcopenia. Moreover, the median OS was 7 months in the sarcopenic group and 32 months in the non-sarcopenic group. Results of the present study further illustrated that SMI, SMA, density and SMG did not exert a significant effect on OS. Notably, the median PFS was 2.5 months in the low SMI group and 10 months in the normal SMI group. Body composition parameters did not exert a significant effect on PFS. Overall, the results of the present study demonstrated that sarcopenia was not a risk factor for decreased OS or PFS in patients with PCNSL undergoing systemic treatment.
Background/Aim: Body composition assessment has shown promising results as a prognostic biomarker as depicted by cross-sectional imaging of several tumor entities including lymphomas. The present study sought to elucidate the prognostic relevance of subcutaneous and visceral fat tissue (SAT and VAT) in patients with primary central nervous system lymphoma (PCNSL). Patients and Methods: Overall, 74 patients (36 female patients, 46.7%) with a mean age of 64.2±12.8 years (range=23-81 years) were identified in the database with sufficient clinical and imaging data and included into this retrospective study. Fat area assessment was performed on one axial slide on L3-height derived from staging computed tomography (CT) images. Subcutaneous, visceral, and intramuscular adipose tissues (SAT, VAT, IMAT) were estimated. Also, density of SAT, VAT, and IMAT were estimated. Finally, the ratio VAT/SAT (VSR) was calculated. Overall and progression-free survival (OS and PFS) were used as study end points. Results: In the observation period, overall, 47 patients (63.5%) died. Mean OS was 33.8±45.4 months and mean PFS was 26.6±42.7 months. The mean VAT value was 162±99.5 cm 2 , the mean SAT was 202.4±103.3 cm 2 , the mean VSR was 0.92±0.69. The hazard ratios (HRs) for overall survival were 0.87 for high VAT, 1.52 for SAT, and 0.73 for VSR in univariable analysis. For PFS it was 0.24 for VAT, 1.11 for SAT, and 1.07 for VSR. No values achieved statistical significance. Similar results were shown in Kaplan-Meier analysis for OS and PFS, respectively. Conclusion: Parameters of adipose tissue are not associated with OS and PFS in patients with PCNSL.
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