Prognostic value of muscle measurement using the standardized phase of computed tomography in patients with advanced ovarian cancer

Huang, Chueh-Yi; Sun, Fang‐Ju; Lee, Jie

doi:10.1016/j.nut.2019.110642

Cited by 26 publications

(41 citation statements)

References 39 publications

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“…In a sample of 90 patients randomly selected from this cohort, intraobserver coefficients of variation were 1.2%, 1.0%, and 1.5% for the skeletal muscle area, SMD, and TAT area, respectively, which is consistent with a previous paper in the literature [20]. The cross-sectional areas of skeletal muscle and TAT were normalized for the patients' heights to calculate the indexes (cm 2 /m 2 ) for skeletal muscle (SMI) and TAT (TATI) [20,25].…”

Section: Computed Tomography-based Body Composition Analysissupporting

confidence: 81%

“…The cross-sectional areas (cm 2 ) of skeletal muscle (including the psoas, paraspinal, transversus abdominis, rectus abdominis, and internal and external oblique muscles) and adipose tissues were calculated. The skeletal muscle density (SMD) was defined as the average radiation attenuation of skeletal muscle area in HUs [25]. The total adipose tissue (TAT) area was the sum of visceral, intermuscular, and subcutaneous adipose tissue areas.…”

Section: Computed Tomography-based Body Composition Analysismentioning

confidence: 99%

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Muscle Loss after Chemoradiotherapy as a Biomarker of Distant Failures in Locally Advanced Cervical Cancer

Lee

Lin

et al. 2020

Cancers

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This study aimed to evaluate whether computed tomography (CT)-based muscle measurement predicts distant failure in patients with locally advanced cervical cancer (LACC). Data from 278 patients with LACC who underwent chemoradiation therapy (CCRT) between 2004 and 2017 were analysed. Changes in the skeletal muscle index (SMI), skeletal muscle density, and total adipose tissue index during CCRT were calculated from CT images taken at the baseline and after CCRT. The predictive capability of CT-based muscle measurement for distant failure was evaluated using Cox proportional hazards regression, Harrell’s concordance index (C-index), and time-dependent receiver operating characteristic curves. SMI loss ≥ 5% was independently associated with worse distant recurrence-free survival (DRFS) (HR: 6.31, 95% CI: 3.18–12.53; p < 0.001). The addition of muscle change to clinical models, including International Federation of Gynaecology and Obstetrics (FIGO) stage, lymph nodes, pathology, and squamous cell carcinoma-antigen, achieved higher C-indices (0.824 vs. 0.756; p < 0.001). Models including muscle change had superior C-indices than those including weight change (0.824 vs. 0.758; p < 0.001). The area under the curve for predicting 3-year DRFS was the highest for the muscle-loss model (0.802, muscle-loss model; 0.635, clinical model; and 0.646, weight-loss model). Our study demonstrated that muscle loss after CCRT was independently associated with worse DRFS and that integrating muscle loss into models including classical prognostic factors improved the prediction of distant failure.

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Section: Computed Tomography-based Body Composition Analysissupporting

confidence: 81%

Section: Computed Tomography-based Body Composition Analysismentioning

confidence: 99%

Muscle Loss after Chemoradiotherapy as a Biomarker of Distant Failures in Locally Advanced Cervical Cancer

Lee

Lin

et al. 2020

Cancers

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“…Body composition was defined based on Hounsfield unit (HU) thresholds, which ranged from −29 to + 150 HU for skeletal muscle, −50 to −150 HU for visceral adipose tissue, and −30 to −190 HU for subcutaneous adipose tissue. Cross-sectional areas (cm 2 ) of the skeletal muscle and visceral and subcutaneous adipose tissues were measured on a single slice of CT by using the Varian Eclipse software (Varian Medical Systems Inc., Palo Alto, CA, USA) [ 25 , 26 , 27 , 28 ]. The sum of the areas of the visceral and subcutaneous adipose tissues was calculated to be total adipose tissue.…”

Section: Methodsmentioning

confidence: 99%

“…Body composition changes can be longitudinally evaluated on computed tomography (CT) scans acquired for routine cancer care ( Figure 1 ) [ 25 , 26 , 27 , 28 , 29 ]. This study aimed to evaluate whether patient-reported GI toxicity and nutritional status are associated with body composition changes in women who underwent pelvic radiotherapy following hysterectomy for cervical or endometrial cancer.…”

Section: Introductionmentioning

confidence: 99%

Association of Patient-Reported Outcomes and Nutrition with Body Composition in Women with Gynecologic Cancer Undergoing Post-Operative Pelvic Radiotherapy: An Observational Study

et al. 2021

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Pelvic radiotherapy is associated with gastrointestinal toxicities and deterioration of nutritional status. This study aimed to investigate the association of patient-reported outcomes (PROs) and nutritional status with body composition changes in women who underwent hysterectomy and post-operative radiotherapy for gynecologic cancer. We analyzed data of 210 patients treated with post-operative pelvic radiotherapy for gynecologic cancer between 2013 and 2018. The PRO version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) was used for gastrointestinal toxicity assessment. The Patient-Generated Subjective Global Assessment (PG-SGA) was used for nutritional assessment. Skeletal muscle index was measured from computed tomography scans at the L3 vertebral level. A reduction in skeletal muscle index ≥ 5% was classified as muscle loss. Odds ratios were calculated through logistic regression models. The PG-SGA score increased from the beginning to the end of radiotherapy (1.4 vs. 3.7, p < 0.001). Patients with PRO-CTCAE scores ≥ 3 had significantly higher PG-SGA scores at the end of radiotherapy than those with PRO-CTCAE scores ≤ 2 (8.1 vs. 2.3, p < 0.001). On multivariable analysis, PRO-CTCAE scores ≥ 3 and PG-SGA scores ≥ 4 at the end of radiotherapy were independently associated with increased risk of muscle loss (odds ratio: 8.81, p < 0.001; odds ratio: 72.96, p < 0.001, respectively). PROs and PG-SGA may be considered as markers of muscle loss after post-operative pelvic radiotherapy for gynecologic cancer.

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“…The cross-sectional areas of the skeletal muscle and adipose tissue on a single CT slice at the level of the third lumbar vertebrae (L3) are strongly correlated with the total body skeletal muscle and adipose mass (12)(13)(14). The skeletal muscle radiodensity (SMD) is a surrogate measure of muscle quality, and skeletal muscle with low SMD is suggestive of fatty infiltration of the skeletal muscle and poor "quality" skeletal muscle (15). A longitudinal study of CT-based composition measures may elucidate how body composition changes impact survival outcomes in these patients (16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Muscle Loss During Androgen Deprivation Therapy Is Associated With Higher Risk of Non-Cancer Mortality in High-Risk Prostate Cancer

et al. 2021

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The changes in body composition are early adverse effects of androgen deprivation therapy (ADT); however, their prognostic impact remains unclear in prostate cancer. This study aimed to evaluate the association between body composition changes and survival in patients with high-risk prostate cancer. We measured the skeletal muscle index (SMI) and total adipose tissue index (TATI) at the L3 vertebral level using computed tomography at baseline and within one year after initiating ADT in 125 patients with high-risk prostate cancer treated with radiotherapy and ADT between 2008 and 2018. Non-cancer mortality predictors were identified using Cox regression models. The median follow-up was 49 months. Patients experienced an average SMI loss of 5.5% over 180 days (95% confidence interval: -7.0 to -4.0; p<0.001) and TATI gain of 12.6% over 180 days (95% confidence interval: 9.0 to 16.2; p<0.001). Body mass index changes were highly and weakly correlated with changes in TATI and SMI, respectively (Spearman ρ for TATI, 0.78, p<0.001; ρ for SMI, 0.27, p=0.003). As a continuous variable, each 1% decrease in SMI was independently associated with a 9% increase in the risk of non-cancer mortality (hazard ratio: 1.09; p=0.007). Moreover, the risk of non-cancer mortality increased 5.6-fold in patients with SMI loss ≥5% compared to those with unchanged SMI (hazard ratio: 5.60; p=0.03). Body mass index and TATI were not associated with non-cancer mortality. Muscle loss during ADT is occult, independent of weight change, and independently associated with increased non-cancer mortality in patients with high-risk prostate cancer.

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Prognostic value of muscle measurement using the standardized phase of computed tomography in patients with advanced ovarian cancer

Cited by 26 publications

References 39 publications

Muscle Loss after Chemoradiotherapy as a Biomarker of Distant Failures in Locally Advanced Cervical Cancer

Muscle Loss after Chemoradiotherapy as a Biomarker of Distant Failures in Locally Advanced Cervical Cancer

Association of Patient-Reported Outcomes and Nutrition with Body Composition in Women with Gynecologic Cancer Undergoing Post-Operative Pelvic Radiotherapy: An Observational Study

Muscle Loss During Androgen Deprivation Therapy Is Associated With Higher Risk of Non-Cancer Mortality in High-Risk Prostate Cancer

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