The predictive and prognostic value of skeletal muscle mass in cancer patients with distant metastases

Year 2023, , 117 - 124, 29.10.2023

Tülay Kuş , Mahmut Çoraplı , Baran Yusufoğlu , Gökmen Aktaş , Cemil Oktay

https://doi.org/10.30565/medalanya.1167930

Abstract

Aim:Skeletal muscle loss is an indicator of cachexia and a strong prognostic factor for some types of cancer. After strict standardization, we aim to evaluate both the predictive and prognostic value of low muscle mass (LMM) in common cancer types for first-line chemotherapy.

Methods: This retrospective single-center study was conducted in a regional hospital between 2015 and 2020. Patients diagnosed with distant metastatic cancer were screened and included in the study if they had abdominal computed tomography 45 days prior to first-line chemotherapy. The relationship between LMM and progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) was evaluated.

Results: Initially, 289 patients with metastatic cancer were included. The median duration of follow-up was 17 months, with a mean age of 61.09±13.03 years (range 25 to 95), and 45.9% of patients were female. In total, 50.5% of patients had LMM, which was adjusted for gender. LMM was associated with worse OS and PFS in univariate analysis (HR:1.598;1.216-2.100; p=0.001 for OS and HR:1.583;1.216-2.059; p=0.001 for PFS), and this positive association was maintained after adjusted for diagnosis and age. Better ORRs were obtained in respiratory and gastrointestinal tract cancers, breast, prostate and gynecological cancer in non-LMM groups.

Conclusion:LMM has not only prognostic value but also predictive value for many types of cancer. Therefore, the assessment of muscle loss should be incorporated as part of the initial routine clinical evaluation.

Keywords

Prediction, muscle mass, prognostic value, cancer, muscle index

Project Number

yok

Uzak metastazlı kanser hastalarında iskelet kası kütlesinin prediktif ve prognostik değeri

Abstract

Amaç: İskelet kası kaybı, kaşeksinin bir göstergesi ve bazı kanser türleri için güçlü bir prognostik faktördür. Bu çalışmada sıkı standardizasyon sonrası, birinci basamak kemoterapi için yaygın kanser türlerinde düşük kas kütlesinin (LMM) hem prognostik hem de prediktif değerini değerlendirmeyi amaçlıyoruz.

Yöntem: Bu retrospektif tek merkezli çalışma 2015-2020 yılları arasında bir bölge hastanesinde yapılmıştır. Uzak metastatik kanser tanısı alan hastalar tarandı ve birinci basamak kemoterapiden 45 gün önce abdomen bilgisayarlı tomografisi olan hastalar çalışmaya dahil edildi. LMM ile genel sağkalım (OS), progresyonsuz sağkalım (PFS) ve objektif yanıt oranı (ORR) arasındaki ilişki değerlendirildi.

Bulgular: Çalışmaya metastatik kanserli 289 hasta dahil edildi. Hastaların %45,9'u kadın olup medyan takip süresi 17 ay ve ortalama yaşı 61,09±13,03 yıldır (min-max: 25-95). Cinsiyete göre düzeltme sonrası, toplamda hastaların %50,5'inde LMM vardı. LMM, univariate analizde daha kötü OS ve PFS ile ilişkilendirildi (OS için HR:1,598;1,216-2,100;p=0,001 ve PFS için HR:1,583;1,216-2,059;p=0,001) ve bu pozitif ilişki tanı ve yaşa göre düzeltme yapıldığında da devam etti. LMM olmayan gruplarda solunum sistemi, gastrointestinal sistem, meme, prostat ve jinekolojik kanserlerde daha iyi ORR'ler elde edildi.

Sonuç: LMM sadece prognostik değere sahip değildir, aynı zamanda birçok kanser türü için prediktif değere de sahiptir. Bu nedenle kas kaybının değerlendirilmesi, ilk muayenede rutin klinik değerlendirmede yer almalıdır.

Keywords

Prediktif değer, kas kütlesi, prognostik değer, kanser, kas indeksi

Supporting Institution

yok

Project Number

yok

Thanks

yok

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