Association of adipose tissue and skeletal muscle metrics with overall survival and postoperative complications in soft tissue sarcoma patients: an opportunistic study using computed tomography

Boutin, Robert D.; Katz, Jeremy; Chaudhari, Abhijit J.; Yabes, Jonathan G.; Hirschbein, Jonah; Nakache, Yves Paul; Seibert, J. Anthony; Lamba, Ramit; Fananapazir, Ghaneh; Canter, Robert J.; Lenchik, Leon

doi:10.21037/qims.2020.02.09

Cited by 23 publications

(23 citation statements)

References 29 publications

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“…Comparability is limited though, because different to our study, that study investigated localized as well as metastatic disease. In two other analyses with higher proportions of patients with more advanced disease, association of sarcopenia with OS was found [33,34]. Therefore, the impact of sarcopenia seems to be more significant in a/mSTS compared to localized disease stages and this might be attributed to higher levels of inflammation found in advanced and metastatic disease linked to cancer cachexia [35].…”

Section: Discussionmentioning

confidence: 82%

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Impact of sarcopenia in advanced and metastatic soft tissue sarcoma

et al. 2021

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Introduction Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Patient counseling on treatment aggressiveness is pivotal to avoid over- or undertreatment. Recently, evaluation of body composition markers like the skeletal muscle index (SMI) became focus of interest in a variety of cancers. This study focuses on the prognostic impact of SMI in a/mSTS, retrospectively. Methods 181 a/mSTS patients were identified, 89 were eligible due to prespecified criteria for SMI assessment. Baseline CT-Scans were analyzed using an institutional software solution. Sarcopenia defining cut-off values for the SMI were established by optimal fitting method. Primary end point was overall survival (OS) and secondary endpoints were progression free survival (PFS), disease control rate (DCR), overall response rate (ORR). Descriptive statistics as well as Kaplan Meier- and Cox regression analyses were administered. Results 28/89 a/mSTS patients showed sarcopenia. Sarcopenic patients were significantly older, generally tended to receive less multimodal therapies (62 vs. 57 years, P = 0.025; respectively median 2.5 vs. 4, P = 0.132) and showed a significantly lower median OS (4 months [95%CI 1.9–6.0] vs. 16 months [95%CI 8.8–23.2], Log-rank P = 0.002). Sarcopenia was identified as independent prognostic parameter of impaired OS (HR 2.40 [95%-CI 1.4–4.0], P < 0.001). Moreover, DCR of first palliative medical treatment was superior in non-sarcopenic patients (49.2% vs. 25%, P = 0.032). Conclusion This study identifies sarcopenia as a prognostic parameter in a/mSTS. Further on, the data suggest that sarcopenia shows a trend of being associated with first line therapy response. SMI is a promising prognostic parameter, which needs further validation.

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Section: Discussionmentioning

confidence: 82%

“…Another possible source of deviation in reported SMI values may be attributed to the use of different software solutions. In this study a self-designed, purpose-built albeit unvalidated software within the MeVisLAB framework is utilized, whereas other studies use commercially available software solutions [33,34].…”

Section: Discussionmentioning

confidence: 99%

Impact of sarcopenia in advanced and metastatic soft tissue sarcoma

et al. 2021

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“…Importantly, visceral obesity de ned as a VFA of ≥ 86.7 cm 2 was identi ed as an independent prognostic factor associated with postoperative complications. In addition, Boutin et al found that there was no signi cant relationship between adipose tissue distribution and postoperative complications in patients with soft tissue sarcoma [25]. The results from three studies on complications of radical resection of gastrointestinal tumors revealed that an increase in visceral fat could lead to a prolonged operation time, poor recovery and postoperative complications [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Visceral Obesity Determined by CT As a Predictor of Short-term Postoperative Complications in Ovarian Cancer

Nie

Zhang

Meng

et al. 2022

Preprint

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Objective: To explore the association between visceral obesity and short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.Methods: Medical records were reviewed for patients with ovarian cancer. Visceral fat area, subcutaneous fat area and total fat area were measured on a single slice at the level of L3/4 of a preoperative CT scan. Univariable and multivariable analyses were performed to investigate the correlation between visceral obesity and short-term complications and to analyze the risk factors for complications after surgery.Results: Of the 130 patients, 53.8% (70/130) were presented visceral obesity. Patients with visceral obesity were older than those with nonvisceral obesity (58.3 years old vs. 52.3 years old, p = 0.001). The proportion of patients with hypertension was slightly higher (37.1% vs. 11.7%, p = 0.001). The total fat area and subcutaneous fat area were higher in patients with visceral obesity (296.9 ± 72.1 vs. 173.1 ± 67.3, p < 0.001; 168.8 ± 55.5 vs. 121.6 ± 54.3, p < 0.001). Compared with patients in the nonvisceral obese group, patients in the visceral obese group were more likely to have postoperative fever (21/70 30.0% vs. 8/60 1.25%, p = 0.023), leading to a longer length of hospital stay (21 days vs. 17 days, p = 0.009). Time from surgery to adjuvant chemotherapy for patients with visceral obesity has been delayed (24 days vs. 20 days, p = 0.037). Multivariate analysis showed that visceral obesity (OR 4.770, p < 0.001) and operation time (OR 1.008, p < 0.001) were independent predictors of postoperative complications. Conclusion: Visceral obesity is an important risk factor for short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.

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“…According to the study of Abe et al (10), other related research (12)(13)(14)(15)(16)(17), and our pre-experiment, 11 sites across the whole body were selected to measure MT, as explained below and as shown in Figure 1.…”

Section: Ultrasound Examinationmentioning

confidence: 99%

Quantitative estimation of muscle mass in older adults at risk of sarcopenia using ultrasound: a cross-sectional study

Tang¹,

Huang²,

Yue³

et al. 2022

Quant Imaging Med Surg

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Background: Sarcopenia is an age-associated syndrome of decreased skeletal muscle function and loss of muscle mass. This cross-sectional study was designed to investigate whether ultrasound can be used to quantitatively estimate muscle mass in older adults as an efficient assistive method for the diagnosis of sarcopenia.Methods: A cohort of 103 older adults older aged over 60 years who were at risk of sarcopenia, including 57 males and 46 females, was recruited. The participants underwent ultrasound to measure the muscle thickness (MT) of 11 sites across the whole body. Bioelectrical impedance analysis (BIA) was then used to estimate the appendicular muscle mass, and the correlation between skeletal muscle mass index (SMI) and MT at different sites was studied. Finally, muscle mass estimation algorithms for older adults were developed using multiple linear regression.Results: Male participants had a significantly higher SMI (7.03±0.73 vs. 5.84±0.72 kg/m 2 , P<0.001) and higher MT than female participants at all 11 sites (all P<0.05). The MT of Site 7 (rectus femoris and intermedius femoris) in males had the strongest correlation with SMI (R=0.719, P<0.001). In females, the MT at Site 3 (flexor pollicis longus, flexor digitorum superficialis, and brachioradialis) had the strongest correlation with SMI (R=0.733, P<0.001). The MT of Site 7 was selected for a one-site algorithm; the R 2 and standard error of estimate (SEE) values were 0.701 and 0.519 kg/m 2 , respectively. The MT of Site 3, Site 7, Site 1 (biceps and brachialis), and Site 9 (tibialis anterior) were selected for a four-site algorithm; the R 2 and SEE values were 0.819 and 0.404 kg/m 2 , respectively.Conclusions: MT measured using ultrasound is correlated with SMI at some sites, and the correlations differ between men and women. When sex and age were included in the algorithm, the MT at Site 1, Site 3, Site 7, and Site 9 were valuable for estimating SMI, with Site 7 being the best parameter among them.Ultrasound-derived algorithms can achieve a satisfying fitting effect and provide new solutions for muscle mass estimation in older adults.

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Association of adipose tissue and skeletal muscle metrics with overall survival and postoperative complications in soft tissue sarcoma patients: an opportunistic study using computed tomography

Cited by 23 publications

References 29 publications

Impact of sarcopenia in advanced and metastatic soft tissue sarcoma

Impact of sarcopenia in advanced and metastatic soft tissue sarcoma

Visceral Obesity Determined by CT As a Predictor of Short-term Postoperative Complications in Ovarian Cancer

Quantitative estimation of muscle mass in older adults at risk of sarcopenia using ultrasound: a cross-sectional study

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