High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting

Antoun, Sami; Bayar, Mohamed Amine; Ileana, Ekatarina; Laplanche, Agnès; Fizazi, Karim; Palma, Mario Di; Escudier, Bernard; Albigès, Laurence; Massard, Christophe; Loriot, Yohann

doi:10.1016/j.ejca.2015.07.042

Cited by 89 publications

(73 citation statements)

References 35 publications

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“…Moreover, having high VATI, without high subcutaneous adiposity increases mortality risk. This result is consistent with Antoun et al who reported that a high amount of subcutaneous adipose tissue independently and significantly associates with longer survival in 120 prostate cancer patients (Antoun et al , 2015). Controversy remains regarding the association between visceral adiposity and cancer survival as visceral adipose tissue is reported to be associated with poorer survival in patients with hepatocellular carcinoma (Fujiwara et al , 2015) or with better prognosis (Kaneko et al , 2015; Lee et al , 2015) in advanced renal cell carcinomas.…”

Section: Discussionsupporting

confidence: 92%

Subcutaneous adiposity is an independent predictor of mortality in cancer patients

et al. 2017

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Background:Prognostic significance of adiposity, at the time of cancer diagnosis, on survival is not clear. Body mass index (kg m−2) does not provide an appropriate assessment of body composition; therefore, the concept of the ‘obesity paradox’ needs to be investigated based on the prognostic significance of fat and muscle. Independent prognostic significance of adipose tissue in predicting mortality, importance of visceral and subcutaneous adiposity in the presence and absence of sarcopenia on survival, was investigated.Methods:Adiposity markers including total adipose index (TATI), visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI) were estimated for 1473 gastrointestinal and respiratory cancer patients and 273 metastatic renal cell carcinoma patients using computed tomography. Univariate and multivariate analysis to determine mortality hazard ratios (HR) were conducted using cox proportional hazard models.Results:Low SATI (SATI <50.0 cm2 m−2 in males and <42.0 cm2 m−2 in females) independently associated with increased mortality (HR: 1.26; 95% CI: 1.11–1.43; P<0.001) and shorter survival (13.1 months; 95% CI, 11.4–14.7) compared to patients with high SATI (19.3 months; 95% CI, 17.6–21.0; P<0.001). In the presence of sarcopenia, the longest survival was observed in patients with high subcutaneous adiposity.Conclusions:Subcutaneous adipose tissues appear to associate with reduction in mortality risk demonstrating the prognostic importance of fat distribution. The effect of sarcopenia on survival was more pronounced in patients with low subcutaneous adiposity.

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Section: Discussionsupporting

confidence: 92%

Subcutaneous adiposity is an independent predictor of mortality in cancer patients

et al. 2017

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“…In a previous study having patients with colon cancer, only the VAT parameters had significant clinical values . In other previous studies with non‐small cell lung cancer, extremity sarcoma, and prostate cancer, only the SAT parameters were significantly associated with clinical outcomes . Considering these results of the previous studies, VAT and SAT could have different characteristics and could be related to tumor cells with different mechanisms according to the type of cancer.…”

Section: Discussionmentioning

confidence: 71%

“…Considering these results of the previous studies, VAT and SAT could have different characteristics and could be related to tumor cells with different mechanisms according to the type of cancer. However, the mechanism of these differences between VAT and SAT is still not exactly known, and further studies are warranted to better understand the metabolic characteristics of VAT and SAT.…”

Section: Discussionmentioning

confidence: 99%

Visceral adipose tissue volume and CT‐attenuation as prognostic factors in patients with head and neck cancer

et al. 2019

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Background The aim of this study was to evaluate the relationship of the characteristics of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) to the disease progression‐free survival and distant failure‐free survival of head and neck squamous cell carcinoma (HNSCC). Methods We enrolled 152 HNSCC patients who underwent staging 18F‐fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT). Maximum FDG uptake (standardized uptake value [SUV]) and total lesion glycolysis (TLG) of the primary tumor and volume, CT‐attenuation (Hounsfield units [HU]), and FDG uptake of SAT and VAT were measured. Survival analysis using Cox proportional hazard modeling was performed to assess the relationship between the adipose tissue parameters of PET/CT and survival. Results Patients with low VAT volume and high VAT HU had significantly worse progression‐free survival and distant failure‐free survival than those with high VAT volume and low VAT HU. On multivariate analysis, the volume and HU of VAT were significantly correlated with disease progression‐free survival and distant failure‐free survival after adjusting for age, sex, body mass index, TNM stage, serum C‐reactive protein, maximum SUV, and TLG. Conclusion The volume and CT‐attenuation of VAT were significantly correlated with disease progression‐free survival and distant failure‐free survival in patients with HNSCC.

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“…From a clinical point of view, it has been observed that a healthy amount of SAT may imply a survival benefit . Specifically, among women with cirrhosis, it was hypothesized that higher SAT allowed these patients to endure weight losses and subsequent longer overall survival; similar findings have been shown in patients with cancer . In animal models, the removal of subcutaneous fat is associated with increase in visceral fat mass, insulin resistance, circulating insulin and TNF‐α .…”

Section: Discussionmentioning

confidence: 94%

Adipopenia correlates with higher portal pressure in patients with cirrhosis

Rodrigues

Brabandt

Stirnimann

et al. 2019

Liver International

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Background & Aims In cirrhosis, hepatic venous pressure gradient (HVPG) and imaging body composition assessment can influence prognosis. We assessed whether adipose and skeletal muscle tissues reflect the severity of portal hypertension (PH), and whether they improve non‐invasive prediction of decompensation and death. Methods We included 84 cirrhosis patients with HVPG and computed tomography (CT) within 12 weeks of HVPG at a single centre. L3 vertebra CT images were used for body composition indexes (cm2/m2): total adipose tissue index (TATI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), intramuscular adipose tissue index (IMATI), skeletal muscle index (SMI) and psoas muscle index (PMI). Correlations were calculated between indexes, HVPG and standard non‐invasive tests for PH. Twelve‐month decompensation and death predictors were determined. Results The following were the characteristics for the patients included in the study: male 61%; BMI 28 ± 5 kg/m2; alcoholic liver disease in 51%, non‐alcoholic steatohepatitis in 24%; HVPG 14 ± 6 mm Hg; 45% compensated. The median follow‐up was 11 (4‐17) months. HVPG correlated with SATI (r = −0.282, P = 0.01), TATI (r = −0.220, P = 0.045) and SATI/VATI index (r = −0.240, P = 0.03). In compensated patients, lower VATI (HR 0.94 (0.90‐0.99), P = 0.01) was associated with 12‐month decompensation. Combining TATI and liver stiffness × spleen size over‐platelet count risk score added discriminative capacity for 12‐month decompensation (AUROC 0.91 vs 0.87). IMATI was independently associated with mortality in decompensated patients. MELD‐Na combined with IMATI discriminated excellently for mortality (AUROC 0.94; P < 0.001). Conclusions Hepatic venous pressure gradient inversely correlates with imaging markers of adipose tissue, while markers of sarcopenia were unrelated to PH. In compensated patients, TATI improves non‐invasive prediction of decompensation. In decompensated patients, IMATI independently predicted mortality.

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High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting

Cited by 89 publications

References 35 publications

Subcutaneous adiposity is an independent predictor of mortality in cancer patients

Subcutaneous adiposity is an independent predictor of mortality in cancer patients

Visceral adipose tissue volume and CT‐attenuation as prognostic factors in patients with head and neck cancer

Adipopenia correlates with higher portal pressure in patients with cirrhosis

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