A lower psoas muscle index predicts a poorer prognosis in metastatic hormone‐naïve prostate cancer

Abstract

Introduction A recent investigation revealed that sarcopenia was associated with a poorer prognosis in some solid malignancies, including prostate cancer. In most reports, sarcopenia was defined as a low psoas volume on CT. This study investigated the association of sarcopenia, determined according to the psoas muscle volume and density on CT, with the prognosis in patients with metastatic hormone‐naïve prostate cancer (mHNPC). Methods A total of 66 patients initially diagnosed with mHNPC were enrolled in this study. Skeletal muscle was evaluated according to the psoas muscle index density (PMID) on computed tomography scans. The psoas muscle volume was calculated at the level of L3 and CT density was evaluated as the mean CT density at the psoas muscle area. We divided the patients into higher and lower PMID groups. Results The lower PMID group (on both sides) showed a poorer overall survival than the higher PMID group (Right: 32.5 vs 99.0 months in Rt PMID, P = .014; Left: 36.0 vs 100.0 months in Lt PMID, P = .029). The lower PMID group (on both sides) showed a shorter time to CRPC (Right: 9.0 vs 42.0 months in Rt PMID, P = .006; Left: 9.0 vs 31.0 months in Lt PMID, P = .005). A multivariate analysis showed that lower Rt PMID and Lt PMID were independent risk factors for poorer OS (HR:2.02, 95%CI: 1.04‐3.90, P = .037, HR:2.29, 95%CI: 1.18‐4.47, P = .015, respectively). For CRPC, both Rt and Lt lower PMID also showed independent risk factors for shorter time to CRPC (HR:2.39, 95%CI: 1.23‐4.62, P = .010, HR:2.43, 95%CI: 1.23‐4.78, P = .010, respectively). Conclusions Among mHNPC patients, both lower PMID groups showed a poorer overall survival and shorter time to CRPC than the higher PMID groups.

Psoas mass index at the level of the third lumbar vertebra on computed tomography is a prognostic predictor for metastatic castration-sensitive prostate cancer

“…We have summarized existing clinical evidence of the oncological outcomes (based on skeletal muscle mass determination using CT imaging) in patients with mCSPC treated with ADT (Table 5) [7][8][9][10]. The present study is the rst to show that a low pretreatment PMI is an independent predictor of a poor CRPC-FS and OS in patients with mCSPC.…”

“…However, most studies on the prognostic body composition factors for PCa have been conducted on patients with castration-resistant prostate cancer (CRPC), who are likely to have sarcopenia [6]. Little is known about the relationship between LSMM and the outcomes of metastatic castration-sensitive prostate cancer (mCSPC) in patients treated with androgen deprivation therapy (ADT) [7][8][9][10]. Accordingly, in this retrospective study, we investigated whether the clinical value of psoas muscle parameters (as de ned by pretreatment CT) was correlated with the CRPC-free survival (CRPC-FS) and OS in patients with mCSPC treated with ADT plus rst-generation antiandrogen (i.e., combined androgen blockade [CAB]).…”

Prognostic Impact of Ectopic Fat Deposition within Psoas Muscle in Stage IV Gastric Cancer Patients Undergoing Systemic Chemotherapy

“…PMI can be helpful for predicting postoperative outcomes in patients with esophageal cancer undergoing surgery 37 . A decreased PMI is associated with poorer prognosis in patients with metastatic hormone-naïve prostate cancer 38 . A decreased PMI predicts cancer recurrence in patients with upper urinary tract urothelial carcinoma 39 .…”

The great escape: A tale of the visiting professor’s Artful Dodge

“…With three papers from Yokohama City, Japan in this issue, will give a travel photo shoutout for Figure 5, the Tokyo Bay version of the Statue of Liberty. To the Drawing Board… We have discussed the Vasdev paper already as part of our editorial theme and this paper will be in our academic section. A second paper, again from the Yokohama City University group in Japan from Iwamoto et al 7 , looked at the problem with sarcopenia as related to metastatic hormone‐naïve prostate cancer. Using CT estimation of lower psoas volume, they could correlate poorer survival and shorter time to castrate resistance in groups with lower psoas muscle index density.…”