The Relationship Between Body Composition and Response to Neoadjuvant Chemotherapy in Women with Operable Breast Cancer

Fabbro, Egidio Del; Parsons, Henrique A.; Warneke, Carla L.; Pulivarthi, Kalyan; Litton, Jennifer K.; Dev, Rony; Palla, Shana L.; Brewster, Abenaa M.; Bruera, Éduardo

doi:10.1634/theoncologist.2012-0169

Cited by 137 publications

(117 citation statements)

References 21 publications

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“…8,11,30,31 Similar prevalences as in our cohort were reported for early breast cancer (14%, n = 18/129). 32 The fact that the mean lumbar skeletal muscle area of nonsarcopenic patients in our study (46.6 T 5.9 cm 2 /m 2 ) was in the same range as reported for female nonsarcopenic patients in the other studies (47.4 T 5.0 cm 2 /m 2 , 8 45.5 T 4.7 cm 2 /m 2 11 ) makes a methodic overestimation of muscle mass in our analysis unlikely. Torres et al 33 had already presented data on the presurgical lumbar skeletal muscle areas of patients with ovarian cancer which were lower than in our cohort.…”

Section: Discussionsupporting

confidence: 70%

Sarcopenia in Advanced Serous Ovarian Cancer

Bronger

Hederich

Hapfelmeier³

et al. 2017

Int J Gynecol Cancer

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Section: Discussionsupporting

confidence: 70%

Sarcopenia in Advanced Serous Ovarian Cancer

Bronger

Hederich

Hapfelmeier³

et al. 2017

Int J Gynecol Cancer

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“…37 Del Fabbro et al (2012) analyzed data from 129 non-metastatic breast cancer patients treated with neoadjuvant chemotherapy at MD Anderson Cancer Centre, Texas, USA. 38 Sarcopenia was defined as skeletal muscle index ≤ 38.5 cm 2 /m 2 measured by CT. There was a trend towards an association between sarcopenia and chance of pathologic complete response (OR=4.97; 95% CI=0.99–16.87) in the overall population.…”

Section: Association With Cancer Recurrence and Survivalmentioning

confidence: 99%

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Feliciano

Chen

2018

Proc. Nutr. Soc.

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Although obesity has now been widely accepted to be an important risk factor for cancer survival, the associations between body mass index and cancer mortality have not been consistently linear. Although morbid obesity has clearly been associated with worse survival, some studies have suggested a U-shaped association with no adverse association with overweight or lower levels of obesity. This “obesity paradox” may be due to the fact that body mass index likely incompletely captures key measures of body composition, including distribution of skeletal muscle and adipose tissue. Fat and lean body mass can be measured using clinically acquired CT scans. Many of the earlier studies focused on patients with metastatic cancer. However, skeletal muscle loss in the metastatic setting may reflect end stage disease processes. Therefore, this article focuses on the clinical implication of low skeletal muscle mass in early stage non-metastatic breast and colorectal cancer where measures of body composition have been shown to be strong predictors of disease-free survival and overall survival and also chemotherapy toxicity and operative risk.

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“…Sarcopenia, defined as decreased skeletal muscle mass Original Article Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multiinstitutional analysis and strength two standard deviations below that of healthy adults, has been used as a clinically significant marker of biological age, and has been found to be associated with functional impairment, perioperative complications, and decreased survival in patients with nonmalignant conditions (4)(5)(6). Changes in body composition on computed topography (CT) imaging occur after neoadjuvant treatment in many cancers, including esophageal and breast cancer (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Mirkin¹,

Luke²,

Gangi³

et al. 2017

J. Gastrointest. Oncol.

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Background: This study's objective was to evaluate the change in sarcopenia score following neoadjuvant chemotherapy (NAC) and to correlate both sarcopenia and change in score with perioperative outcomes in patients with advanced resected gastric cancer.Methods: Multi-institutional analysis of patients with gastric cancer who underwent NAC and resection from 2000-2015 was performed. Demographic and perioperative data were included. Sarcopenia score was defined as CT measurement of total psoas muscle at L3, stratified by height (m). Sarcopenia was defined as a score <385 mm 2 /m 2 in women and <545 mm 2 /m 2 in men.Results: Of 36 patients, 19% were sarcopenic prior to NAC. Following NAC, 31% were sarcopenic, with 14% developing sarcopenia during NAC. One patient (3%) became non-sarcopenic. There were no significant differences in patient, disease, or surgery characteristics between patients who were sarcopenic vs.not. Patients with sarcopenia were more likely to have post-operative complications (P=0.05). There was no significant difference in hospital stay (P=0.7402) or survival (P=0.2317).Conclusions: A significant number of patients with gastric cancer become sarcopenic during NAC.Although patients with sarcopenia were nearly twice as likely to develop post-operative complications, this did not appear to impact length of stay (LOS) or survival. and strength two standard deviations below that of healthy adults, has been used as a clinically significant marker of biological age, and has been found to be associated with functional impairment, perioperative complications, and decreased survival in patients with nonmalignant conditions (4-6). Changes in body composition on computed topography (CT) imaging occur after neoadjuvant treatment in many cancers, including esophageal and breast cancer (7)(8)(9)(10).This study sought to understand the impact of NAC on sarcopenia and to evaluate whether sarcopenia is correlated with perioperative outcomes in patients with advanced resected gastric cancer. Methods Patient selectionThis was a multi-institutional, retrospective cohort study. Records of patients who underwent NAC and surgery for gastric adenocarcinoma at Penn State Hershey Medical Center and Moffitt Cancer Center from March 2000 to April 2015 were reviewed. Only patients who had both pre-NAC and post-NAC CT or positron emission tomography (PET-CT) scans, were included in final analysis. Outcomes and covariatesPatient characteristics [including age, sex, body mass index (BMI), comorbidities, pre-operative weight], disease characteristics [American Joint Committee on Cancer (AJCC) T and N stage, tumor size, lymph nodes], and treatment characteristics (surgical approach, type of resection, NAC regimen, surgical margins) were retrospectively collected from the electronic medical record. Post-operative complications, hospital length of stay (LOS), and overall survival were the primary outcomes. Surgical complications were classified by the Clavien-Dindo Classification of Surgical Complications Scale, which grades com...

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The Relationship Between Body Composition and Response to Neoadjuvant Chemotherapy in Women with Operable Breast Cancer

Cited by 137 publications

References 21 publications

Sarcopenia in Advanced Serous Ovarian Cancer

Sarcopenia in Advanced Serous Ovarian Cancer

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

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