Derivation and validation of thoracic sarcopenia assessment in patients undergoing thoracic endovascular aortic repair

Panthofer, Annalise M.; Olson, Sydney L.; Harris, Donald G.; Matsumura, Jon S.

doi:10.1016/j.jvs.2018.08.180

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…Although less often investigated than at the L3 level, muscle metrics at the T12 level have also been validated in assessment of outcomes in patients with other forms of cancer besides STS 17‐19 . Direct comparisons of muscle metrics measured at T12 vs L3 yield similar results in patients undergoing thoracic endovascular aortic repair, with agreement assessed yielding nearly perfect Cohen κ values (>0.85) 20 . Our study aims to analyze both muscle quantity (ie, SMI) and quality (ie, SMD) at the T12 vertebral level on staging chest CTs and determine their association with overall survival and event‐free survival in patients with grade 2 or 3 extremity and trunk STS undergoing surgical resection.…”

Section: Introductionmentioning

confidence: 99%

Opportunistic muscle measurements on staging chest CT for extremity and truncal soft tissue sarcoma are associated with survival

Phan

Thorpe

Wong

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Computed tomography (CT) measurements of sarcopenia have been proposed as biomarkers associated with outcomes in various cancers and have typically been evaluated at the L3 vertebral level. However, staging imaging for patients with extremity and truncal soft tissue sarcoma (STS) often only includes chest CT imaging which precludes evaluation at L3. Therefore, we sought to evaluate muscle metrics at T12 on standard staging chest CT scans and evaluate for correlation with overall and event‐free survival in patients with STS. Methods CT chest imaging for 89 patients with intermediate and high‐grade STS (53 male, 36 female; 58.5 ± 19.0 years old, follow‐up 37.4 ± 27.1 months) was reviewed on PACS at T12 for skeletal muscle density (SMD) and skeletal muscle index (SMI). Results Overall survival increased with increased SMD on univariate (hazard ratio [HR] = 0.61 [0.43, 0.86]) and age‐adjusted analysis (HR = 0.65 [0.42, 0.89]. Event‐free survival also increased with increased SMD in univariate analyses (HR = 0.68 [0.49, 0.95]) but did not maintain significance after adjusting for age (HR = 0.68 [0.43, 1.07]). SMI was not a predictor of overall or event‐free survival. Conclusions Higher SMD measured on routinely obtained staging chest CTs in STS patients is associated with improved survival.

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Section: Introductionmentioning

confidence: 99%

Opportunistic muscle measurements on staging chest CT for extremity and truncal soft tissue sarcoma are associated with survival

Phan

Thorpe

Wong

et al. 2020

Journal of Surgical Oncology

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“…Finally, this study defined sarcopenia based solely on skeletal muscle mass as measured by chest CT and did not directly assess physical activity or muscle function levels such as walking speed and grip strength due to retrospective design. However, considering previous reports [26,31], ESM and PM measurements using chest CT may reflect both physical activity and physiological parameters.…”

Section: Discussionmentioning

confidence: 86%

“…The main advantage of skeletal muscle mass measurement at the level of T2 and T12, compared to the commonly used skeletal muscle mass measurement at the level of L3, is that nearly all patients undergoing cardiac surgery have chest CT images available. With these insights, previous studies investigated a relationship between skeletal muscle mass at the levels of L3 and T12 and suggested that skeletal muscle mass measured at the level of T12 could be used for the diagnosis of sarcopenia in patients with chest CT alone [30,31]. Tanimura et al found that CT-derived ESM at the level of T12 in patients with chronic obstructive pulmonary disease was an independent prognostic factor in survival [32].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia as a prognostic factor for outcomes after isolated tricuspid valve surgery

Song

Nam

et al. 2020

Journal of Cardiology

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“…27 Thoracic sarcopenia in TEVAR patients has been shown to be correlated with psoas muscle area and can also provide an assessment of sarcopenia in TEVAR patients. 28 Although the preoperative utility of quantifying sarcopenia is limited by the need for CT imaging and an experienced imaging reader, it should be considered in conjunction with ECOG scoring, when available, to provide a clearer picture of operative risk.…”

Section: Discussionmentioning

confidence: 99%

Functional performance status and risk of cardiovascular events and mortality following endovascular repair of thoracic and abdominal aortic pathology

et al. 2021

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Objective To characterize the association of preoperative functional performance status based on Eastern Cooperative Oncology Group (ECOG) scoring with the risk of adverse cardiovascular events, vascular events, and mortality in patients undergoing EVAR and TEVAR. Methods Retrospective review of the Society for Vascular Surgery Vascular Quality Initiative, a large, multi-center, registry database was performed. All individuals undergoing EVAR ( n = 18,730) and TEVAR ( n = 6595) for non-ruptured aortic pathologies between 2014 and 2018 were eligible for analysis. Multivariable logistic regression was used to determine the association of pre-procedure ECOG functional performance status on risk of in-hospital adverse cardiovascular events, vascular events, and mortality. Results The number of operations complicated by adverse cardiovascular and vascular events was 480 (2.6%) and 190 (1.0%) for EVAR and 733 (11.1%) and 219 (3.3%) for TEVAR, respectively. There were 118 (0.6%) and 240 (3.6%) in-hospital deaths following EVAR and TEVAR, respectively. Patients with ECOG grades 3 or 4 undergoing EVAR were at increased risk of cardiovascular events (OR = 1.62; 95% CI = 1.09, 2.41) and one-year mortality (HR = 2.62; 95% CI = 1.92, 3.57) compared to those with ECOG grade 0. Patients undergoing TEVAR with ECOG grade 3 or 4 were at increased risk for both inpatient death (OR = 2.77; 95% CI = 1.56, 4.9) and one-year mortality (HR = 3.27, 95% CI = 2.06, 5.21). ECOG status was not associated with an increased risk of adverse vascular events following either EVAR or TEVAR. Conclusions Poor preoperative functional status as assessed by ECOG score is associated with an increased risk of adverse postoperative cardiovascular events following EVAR and a higher mortality risk following both EVAR and TEVAR. Functional status assessment may be useful for risk stratification and determining procedural candidacy prior to EVAR and TEVAR.

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Derivation and validation of thoracic sarcopenia assessment in patients undergoing thoracic endovascular aortic repair

Cited by 22 publications

References 21 publications

Opportunistic muscle measurements on staging chest CT for extremity and truncal soft tissue sarcoma are associated with survival

Opportunistic muscle measurements on staging chest CT for extremity and truncal soft tissue sarcoma are associated with survival

Sarcopenia as a prognostic factor for outcomes after isolated tricuspid valve surgery

Functional performance status and risk of cardiovascular events and mortality following endovascular repair of thoracic and abdominal aortic pathology

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