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Camilleri GM, Delrieu L, Bouleuc C, Pierga JY, Cottu P, Berger F, Raynard B, Cyrille S, Marchal T. Prevalence and survival implications of malnutrition and sarcopenia in metastatic breast cancer: A longitudinal analysis. Clin Nutr 2024; 43:1710-1718. [PMID: 38908032 DOI: 10.1016/j.clnu.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/28/2024] [Accepted: 06/08/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Malnutrition and sarcopenia are challenges for patients with metastatic breast cancer and have been proposed as independent prognostic factors. Very few studies have addressed the temporal evolution of these parameters and, notably, the separate and combined analysis of sarcopenia and malnutrition. This study aimed to i) determine the prevalence of malnutrition and sarcopenia, individually and combined, and their evolution over time, ii) identify risk factors for each condition, and iii) explore their impact on overall survival (OS). METHODS This retrospective study was conducted on 111 patients treated for at least a third-line metastatic breast cancer at the Institut Curie between January 1st and March 31st, 2018. Solitary malnutrition was defined from weight loss and body mass index values while solitary sarcopenia was defined solely based on low muscle mass. We analyzed solitary malnutrition, solitary sarcopenia, and then malnutrition with or without sarcopenia, at three key stages (T1: diagnosis of metastasis, T2: initiation of third-line treatment, and T3: 3-month re-evaluation). Univariate and multivariate logistic regression analyses were conducted to investigate the risk factors. We performed Cox proportional hazards analyses for each variable. RESULTS At T1, the prevalence of solitary malnutrition, solitary sarcopenia and malnutrition with or without sarcopenia was 18.6%, 36.1% and 48.9% respectively, increasing to 27.7%, 45.5% and 56.6% at T2. At T2, in multivariate logistic regression analyses, patients aged over 60 years were at an elevated risk of experiencing solitary malnutrition as well as malnutrition with or without sarcopenia, but not solitary sarcopenia. In multivariate analyses, solitary malnutrition was significantly associated with poorer OS (HR 2.2 [95% CI 1.1-4.1], p = 0.02), while solitary sarcopenia and malnutrition with or without sarcopenia showed no association. CONCLUSION Solitary malnutrition and sarcopenia were highly prevalent in patients with metastatic breast cancer, affecting around a quarter and half of patients respectively at third-line treatment initiation. Notably, solitary malnutrition emerged as a prognostic factor for overall survival, whereas no significant association was observed for solitary sarcopenia or malnutrition with or without sarcopenia. This highlights the critical need for early identification of patients at risk of malnutrition and the importance of timely intervention.
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Affiliation(s)
| | - Lidia Delrieu
- Residual Tumour & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; Institute for Biomedical and Epidemiological Research in Sport, EA7329, Paris, France University, Paris, France; INSEP, Institut National du Sport de l'Expertise et de la Performance, Paris, France
| | - Carole Bouleuc
- Department of Supportive Care, Institut Curie, 75005 Paris, France
| | - Jean-Yves Pierga
- Department of Medical Oncology, Institut Curie, 26 Rue d'Ulm, 75005, Paris, France; Circulating Tumor Biomarkers laboratory, Inserm CIC-BT 1428, Institut Curie, Paris France; Université Paris Cité, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
| | - Frédérique Berger
- Institut Curie, PSL Research University, DREH, Department of Biometrics, Saint-Cloud, France
| | - Bruno Raynard
- Department of Supportive Care, Unit of Nutrition, Gustave Roussy, 24 Rue Albert Thuret, 94550 Chevilly-Larue, France
| | - Stacy Cyrille
- Institut Curie, PSL Research University, DREH, Department of Biometrics, Saint-Cloud, France
| | - Timothée Marchal
- Department of Supportive Care, Institut Curie, 75005 Paris, France.
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Dastych M, Holánek M, Gottwaldová J, Čermáková Z, Mikušková A. Impact of breast cancer neoadjuvant chemotherapy on plasma and urine amino acid profile, plasma proteins and nitrogen metabolism. Scand J Clin Lab Invest 2024; 84:237-244. [PMID: 38934425 DOI: 10.1080/00365513.2024.2369982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/28/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
Neoadjuvant chemotherapy (NAC) is the preferred treatment option in locally advanced breast cancer (BC). The administration of NAC is associated with a wide range of adverse effects. This pilot observational prospective study examined the effect of NAC using anthracycline + cyclophosphamide (AC) followed by paclitaxel (PTx) on a portfolio of 22 plasma and urinary amino acids, plasma proteins (albumin, prealbumin, transferrin), and products of nitrogen metabolism (urea, creatinine, uric acid) in plasma and urine. Plasma and 24-h urine samples were obtained from ten patients with early breast cancer (N1-3 N0-2 M0), at the following time points: before the start of NAC and during the AC/PTx treatment period (a total of 8 measurements at three-weekly intervals). Amino acids were analyzed using ion exchange chromatography. There were no significant differences in the measured parameters in plasma and urine between pre-NAC and during AC- and PTx-treatment. No trend was detected. A significant difference in the portfolio of plasma and urinary amino acids was found only in the pre-treatment period compared to the control group. Levels of eight plasma amino acids (8/22) were significantly reduced and those of nine urine amino acids were increased (9/22). Nitrogenous catabolites in plasma and urine were not indicative of increased protein catabolism during the anthracycline and taxane treatment periods. A slightly positive nitrogen balance was accompanied by an average weight gain of 3.3 kg (range 0-6 kg). The AC/PTx treatment regimen did not cause significant changes in the monitored laboratory parameters.
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Affiliation(s)
- Milan Dastych
- Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Laboratory Method, Faculty of Medicine Masaryk University, Brno, Czech Republic
| | - Miloš Holánek
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jana Gottwaldová
- Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Zdenka Čermáková
- Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Alena Mikušková
- Department of Paediatric Haematology and Biochemistry, Children's University Hospital Brno, Brno, Czech Republic
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Yücel KB, Aydos U, Sütcüoglu O, Kılıç ACK, Özdemir N, Özet A, Yazıcı O. Visceral obesity and sarcopenia as predictors of efficacy and hematological toxicity in patients with metastatic breast cancer treated with CDK 4/6 inhibitors. Cancer Chemother Pharmacol 2024; 93:497-507. [PMID: 38436714 DOI: 10.1007/s00280-024-04641-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/22/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE We aimed to investigate whether visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area (SMA) index are predictive for efficacy and hematological toxicity in ER + HER2-metastatic breast cancer (BC) patients who received CDK 4/6 inhibitors. METHODS This retrospective cohort study analyzed 52 patients who were treated with CDK 4/6 inhibitors between January 2018 and February 2021. The values of VAT, SAT, SMA indices and hematological parameters were noted before the start, at the third and sixth months of this treatment. The skeletal muscle area (SMA) and adipose tissue measurements were calculated at the level of the third lumbar vertebra. A SMA-index value of <40 cm2/m2 was accepted as the threshold value for sarcopenia. RESULTS Patients with sarcopenia had a worse progression-free survival (PFS) compared to patients without sarcopenia (19.6 vs. 9.0 months, p = 0.005). Patients with a high-VAT-index had a better PFS (20.4 vs. 9.3 months, p = 0.033). Only the baseline low-SMA- index (HR: 3.89; 95% CI: 1.35-11.25, p = 0.012) and baseline low-VAT-index (HR: 2.15; 95% CI: 1.02-4.53, p = 0.042) had significantly related to poor PFS in univariate analyses. The low-SMA-index was the only independent factor associated with poor PFS (HR: 3.99; 95% CI: 1.38-11.54, p = 0.011). No relationship was observed between body composition parameters and grade 3-4 hematological toxicity. CONCLUSION The present study supported the significance of sarcopenia and low visceral adipose tissue as potential early indicators of poor PFS in patients treated with CDK 4/6 inhibitors.
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Affiliation(s)
| | - Uguray Aydos
- Department of Nuclear Medicine, Gazi University, Ankara, Turkey
| | - Osman Sütcüoglu
- Department of Medical Oncology, Gazİ University, Ankara, Turkey
| | | | - Nuriye Özdemir
- Department of Medical Oncology, Gazİ University, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Gazİ University, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Gazİ University, Ankara, Turkey
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Isıklar A, Yilmaz E, Basaran G. The Relationship Between Body Composition and Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Patients. Cureus 2024; 16:e61145. [PMID: 38933645 PMCID: PMC11199927 DOI: 10.7759/cureus.61145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/28/2024] Open
Abstract
Background The pathological response rate in operable breast cancer (BC) patients receiving neoadjuvant chemotherapy (NAC) is postulated to be related to body composition. The success of complete pathological response (pCR) is a known prognostic factor in BC patients treated with NAC. We aimed to accurately measure body composition through BMI and skeletal muscle mass and observe their effects on pCR. Materials and methods Patients diagnosed with operable BC who had a positron emission tomography-computed tomography (PET-CT) or chest/abdominal CT taken at the time of diagnosis were retrospectively screened and enrolled in this study. Muscle mass was defined by third lumbar vertebra (L3) level transverse CT images, and data, including weight and height, were collected from the chemotherapy records. All these data were evaluated together with the postoperative pathological results. Results Sixty-nine operable BC patients with a median age of 46 (range: 29-72) years were included in the study. In all patients, regardless of sarcopenia, 23% (n = 16) achieved pCR to NAC. The pCR rate was 37.5% (n=6) in sarcopenic patients and 62.5% (n=10) in non-sarcopenic patients (p = 0.530). Overweight (n=4; 25%) and obese (n=2; 12.5%) patients also had a lower pathological response than normal-weight (n=10; 62.5%) BC patients (p=0.261). Conclusion Both sarcopenia and obesity independently and synergistically contribute to poorer pathological responses after NAC. Addressing these conditions through tailored interventions, such as nutritional support, exercise programs, and careful monitoring of body composition, could improve treatment outcomes. Further research with larger patient populations and comprehensive body measurements is essential to fully understand these relationships and develop effective strategies to mitigate their impact.
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Affiliation(s)
- Aysun Isıklar
- Internal Medicine, Acıbadem Ataşehir Hospital, Istanbul, TUR
| | - Ebru Yilmaz
- Radiology, Acıbadem Altunizade Hospital, Istanbul, TUR
| | - Gul Basaran
- Oncology, Acıbadem Altunizade Hospital, Istanbul, TUR
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Kanemura T, Takeoka T, Sugase T, Urakawa S, Masuike Y, Shinno N, Hara H, Kitakaze M, Kubo M, Mukai Y, Sueda T, Hasegawa S, Akita H, Nishimura J, Wada H, Yasui M, Omori T, Miyata H. Significance of Comprehensive Analysis of Preoperative Sarcopenia Based on Muscle Mass, Muscle Strength, and Physical Function for the Prognosis of Patients with Esophageal Cancer. Ann Surg Oncol 2024; 31:818-826. [PMID: 37989955 DOI: 10.1245/s10434-023-14306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/06/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The assessment of muscle mass loss, muscle strength, and physical function has been recommended in diagnosing sarcopenia. However, only muscle mass has been assessed in previous studies. Therefore, this study investigated the effect of comprehensively diagnosed preoperative sarcopenia on the prognosis of patients with esophageal cancer. METHODS The study analyzed 115 patients with esophageal cancer (age ≥ 65 years) who underwent curative esophagectomy. Preoperative sarcopenia was analyzed using the skeletal mass index (SMI), handgrip strength, and gait speed based on the Asian Working Group for Sarcopenia 2019 criteria. Clinicopathologic factors, incidence of postoperative complications, and overall survival (OS) were compared between the sarcopenia and non-sarcopenia groups. The significance of the three individual parameters also was evaluated. RESULTS The evaluation identified 47 (40.9%) patients with low SMI, 31 (27.0%) patients with low handgrip strength, and 6 (5.2%) patients with slow gait speed. Sarcopenia was diagnosed in 23 patients (20%) and associated with older age and advanced pT stage. The incidence of postoperative complications did not differ significantly between the two groups. Among the three parameters, only slow gait speed was associated with Clavien-Dindo grade 2 or greater complications. The sarcopenia group showed significantly worse OS than the non-sarcopenia group. Those with low handgrip strength tended to have worse OS, and those with slow gait speed had significantly worse OS than their counterparts. CONCLUSIONS Preoperative sarcopenia diagnosed using skeletal muscle mass, muscle strength, and physical function may have an impact on the survival of patients with esophageal cancer.
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Affiliation(s)
- Takashi Kanemura
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Tomohira Takeoka
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Takahito Sugase
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Shinya Urakawa
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Yasunori Masuike
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Naoki Shinno
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hisashi Hara
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masatoshi Kitakaze
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masahiko Kubo
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Yousuke Mukai
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Toshinori Sueda
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Shinichiro Hasegawa
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hirofumi Akita
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroshi Wada
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Masayoshi Yasui
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Takeshi Omori
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroshi Miyata
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan.
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Sim JH, Kim YH, Lee S, Park HS, Koh WU, Jang DM, Choi WJ. Association between Sarcopenia and Survival in Patients Undergoing Gamma Knife Surgery for Brain Metastasis from Breast Cancer: A Retrospective Single-centre Cohort Study. Clin Oncol (R Coll Radiol) 2024; 36:e87-e96. [PMID: 38114358 DOI: 10.1016/j.clon.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/27/2023] [Accepted: 11/09/2023] [Indexed: 12/21/2023]
Abstract
AIMS Many recent studies related to cancer surgery have reported that sarcopenia influences mortality in surgical patients. However, few comprehensive studies have examined the associations between sarcopenia and short- and long-term surgical outcomes of metastatic cancer, especially breast cancer with brain metastasis. In the present study, we investigated the association between sarcopenia and mortality in patients who underwent gamma knife radiosurgery (GKRS) for brain metastasis with breast cancer. MATERIALS AND METHODS This retrospective study analysed 157 patients who underwent GKRS for brain metastasis with breast cancer between January 2014 and December 2018. A Cox regression analysis was carried out to evaluate the association between sarcopenia and mortality at 90 days, 180 days, 1 year, 3 years and the overall period. RESULTS In the Cox regression analysis, sarcopenia was significantly associated with high 90-day mortality (adjusted hazard ratio 3.46, 95% confidence interval 1.24-9.67, P = 0.018), 180-day mortality (adjusted hazard ratio 2.67, 95% confidence interval 1.37-5.22, P = 0.004), 1-year mortality (adjusted hazard ratio 2.39, 95% confidence interval 1.42-4.02, P = 0.001), 3-year mortality (adjusted hazard ratio 2.39, 95% confidence interval 1.53-3.74, P < 0.001) and overall mortality (adjusted hazard ratio 2.11, 95% confidence interval 1.37-3.26, P < 0.001). CONCLUSION Sarcopenia could be a risk factor for short- and long-term mortality in patients undergoing GKRS for brain metastasis from breast cancer.
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Affiliation(s)
- J-H Sim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y-H Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Lee
- Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - H-S Park
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - W U Koh
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - D-M Jang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - W-J Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Roberto M, Barchiesi G, Resuli B, Verrico M, Speranza I, Cristofani L, Pediconi F, Tomao F, Botticelli A, Santini D. Sarcopenia in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:596. [PMID: 38339347 PMCID: PMC10854936 DOI: 10.3390/cancers16030596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: We estimated the prevalence and clinical outcomes of sarcopenia among breast cancer patients. (2) Methods: A systematic literature search was carried out for the period between July 2023 and October 2023. Studies with breast cancer patients evaluated for sarcopenia in relation to overall survival (OS), progression-free survival (PFS), relapse of disease (DFS), pathological complete response (pCR), or toxicity to chemotherapy were included. (3) Results: Out of 359 screened studies, 16 were eligible for meta-analysis, including 6130 patients, of whom 5284 with non-MBC. Sarcopenia was evaluated with the computed tomography (CT) scan skeletal muscle index and, in two studies, with the dual-energy x-ray absorptiometry (DEXA) appendicular lean mass index. Using different classifications and cut-off points, overall, there were 2007 sarcopenic patients (33%), of whom 1901 (95%) presented with non-MBC. Sarcopenia was associated with a 33% and 29% higher risk of mortality and progression/relapse of disease, respectively. Sarcopenic patients were more likely to develop grade 3-4 toxicity (OR 3.58, 95% CI 2.11-6.06, p < 0.0001). In the neoadjuvant setting, a higher rate of pCR was observed among sarcopenic patients (49%) (OR 2.74, 95% CI 0.92-8.22). (4) Conclusions: Our meta-analysis confirms the correlation between sarcopenia and negative outcomes, especially in terms of higher toxicity.
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Affiliation(s)
- Michela Roberto
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Giacomo Barchiesi
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Blerina Resuli
- Department of Medicine V, University Hospital Munich, Ziemssenstraße 5, 80336 Munich, Germany
| | - Monica Verrico
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Iolanda Speranza
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Leonardo Cristofani
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy;
| | - Federica Tomao
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy;
| | - Andrea Botticelli
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
| | - Daniele Santini
- UOC Oncologia A, Department of Hematology, Oncology and Dermatology, Policlinico Umberto I University Hospital, Sapienza University o f Rome, Viale Regina Elena, 324, 00161 Rome, Italy; (M.R.); (G.B.); (M.V.); (I.S.); (L.C.); (A.B.); (D.S.)
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8
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McCabe FJ, McCabe JP, Murray O. Reply to letter to the editor regarding "A novel scoring system incorporating sarcopenia to predict postoperative survival in spinal metastasis". Spine J 2023; 23:1401-1402. [PMID: 37611973 DOI: 10.1016/j.spinee.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 08/25/2023]
Affiliation(s)
- Fergus J McCabe
- Spine Service, Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Galway, Ireland; University of Galway, Galway, Ireland.
| | - John P McCabe
- Spine Service, Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Galway, Ireland; University of Galway, Galway, Ireland
| | - Odhrán Murray
- Spine Service, Department of Trauma and Orthopedic Surgery, Galway University Hospitals, Galway, Ireland
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9
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Jang MK, Park S, Park C, Doorenbos A, Go J, Kim S. Hematologic toxicities, sarcopenia, and body composition change in breast cancer patients undergoing neoadjuvant chemotherapy. Support Care Cancer 2023; 31:419. [PMID: 37354335 DOI: 10.1007/s00520-023-07890-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE Evaluation of body composition and sarcopenia status could provide evidence for more sensitive prediction of chemotherapy toxicities and support mitigation of the negative impacts of chemotherapy. This study evaluated associations among hematologic toxicities, sarcopenia, and body composition change in breast cancer patients undergoing neoadjuvant chemotherapy. METHODS This retrospective cohort study employed data from 298 breast cancer patients undergoing neoadjuvant chemotherapy. We evaluated two abdominal computed tomography scans before and after neoadjuvant chemotherapy to identify body composition change. As hematologic toxicities, severe (grade 3 or 4) anemia, neutropenia, and thrombocytopenia were assessed throughout the treatment period using Common Terminology Criteria for Adverse Events (version 5.0). RESULTS Participants experienced severe neutropenia (23.5%), anemia (7.1%), and thrombocytopenia (0.7%) during chemotherapy. After chemotherapy, the group with sarcopenia had double the anemia prevalence of the group without sarcopenia (p < 0.001). The group with anemia had significantly decreased skeletal muscle index (SMI, p = .0013) and subcutaneous fat index (SFI, p = .0008). Almost 50% of the sarcopenia group treated with an AC-T (weekly) regimen (combined anthracycline and cyclophosphamide followed by a weekly taxane) had neutropenia. Multiple logistic regression showed that the AC-T (weekly) group had higher neutropenia prevalence than other regimen groups. CONCLUSION Our findings of higher anemia prevalence in breast cancer patients with sarcopenia and decreased SMI and SFI after neoadjuvant chemotherapy provide evidence of a relationship between anemia and body composition change. Early screening and combined consideration of body composition change, sarcopenia status, and chemotherapy regimen could improve clinical outcomes.
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Affiliation(s)
- Min Kyeong Jang
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Park
- Department of Biobehavioral Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, IL, USA
| | - Ardith Doorenbos
- Department of Biobehavioral Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Jieon Go
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sue Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
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10
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Yamanouchi K, Murakami S, Sato A, Ogawa S, Shinagawa H, Kamohara Y. Integrated Evaluation of Inflammatory, Nutritional, and Sarcopenia Markers to Predict Survival in Metastatic Breast Cancer Patients. In Vivo 2023; 37:811-817. [PMID: 36881066 PMCID: PMC10026678 DOI: 10.21873/invivo.13146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND/AIM The prognosis of a cancer patient is influenced by the tumor-related factors, as well as by various patient-related factors. We evaluated the association between inflammatory and nutritional factors and their outcomes, including the prognosis and therapeutic course, in patients with metastatic breast cancer. PATIENTS AND METHODS In this observational retrospective study, we evaluated 35 patients. The inflammatory and nutritional markers before systemic therapy included the lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), pan-immuno-inflammatory values (PIV), prognostic nutritional index (PNI), Glasgow prognostic score (GPS), and psoas muscle index (PMI). RESULTS Triple-negative, low PNI, and GPS 2 were correlated with worse overall survival in the univariable analysis. The GPS was the only independent predictor of overall survival [hazard ratio=5.85, 95% confidence interval=1.15-29.68, p<0.01]. The time to treatment failure of first-line therapy in patients with GPS 2 was significantly shorter than that in patients with GPS 0/1 (p<0.01). CONCLUSION The GPS was an independent predictive marker for overall survival in patients with metastatic breast cancer.
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Affiliation(s)
- Kosho Yamanouchi
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Shunsuke Murakami
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Ayaka Sato
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Shinichiro Ogawa
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Hiromitsu Shinagawa
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
| | - Yukio Kamohara
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, Japan
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Couderc AL, Liuu E, Boudou-Rouquette P, Poisson J, Frelaut M, Montégut C, Mebarki S, Geiss R, ap Thomas Z, Noret A, Pierro M, Baldini C, Paillaud E, Pamoukdjian F. Pre-Therapeutic Sarcopenia among Cancer Patients: An Up-to-Date Meta-Analysis of Prevalence and Predictive Value during Cancer Treatment. Nutrients 2023; 15:nu15051193. [PMID: 36904192 PMCID: PMC10005339 DOI: 10.3390/nu15051193] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
This study will address the prevalence of pre-therapeutic sarcopenia (PS) and its clinical impact during cancer treatment among adult cancer patients ≥ 18 years of age. A meta-analysis (MA) with random-effect models was performed via a MEDLINE systematic review, according to the PRISMA statement, focusing on articles published before February 2022 that reported observational studies and clinical trials on the prevalence of PS and the following outcomes: overall survival (OS), progression-free survival (PFS), post-operative complications (POC), toxicities (TOX), and nosocomial infections (NI). A total of 65,936 patients (mean age: 45.7-85 y) with various cancer sites and extensions and various treatment modes were included. Mainly defined by CT scan-based loss of muscle mass only, the pooled prevalence of PS was 38.0%. The pooled relative risks were 1.97, 1.76, 2.70, 1.47, and 1.76 for OS, PFS, POC, TOX, and NI, respectively (moderate-to-high heterogeneity, I2: 58-85%). Consensus-based algorithm definitions of sarcopenia, integrating low muscle mass and low levels of muscular strength and/or physical performance, lowered the prevalence (22%) and heterogeneity (I2 < 50%). They also increased the predictive values with RRs ranging from 2.31 (OS) to 3.52 (POC). PS among cancer patients is prevalent and strongly associated with poor outcomes during cancer treatment, especially when considering a consensus-based algorithm approach.
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Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine Geriatrics and Therapeutic Unit, APHM, 13009 Marseille, France
- CNRS, EFS, ADES, Aix-Marseille University, 13015 Marseille, France
| | - Evelyne Liuu
- Department of Geriatrics, CHU Poitiers, 86000 Poitiers, France
- CIC1402 INSERM Unit, Poitiers University Hospital, 86000 Poitiers, France
| | - Pascaline Boudou-Rouquette
- Ariane Program, Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, APHP, 75014 Paris, France
- INSERM U1016-CNRS UMR8104, Cochin Institute, Paris Cancer Institute CARPEM, Paris Cité University, 75015 Paris, France
| | - Johanne Poisson
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
- Faculty of Health, Paris Cité University, 75006 Paris, France
| | - Maxime Frelaut
- Department of Medical Oncology, Gustave Roussy Institute, 94805 Villejuif, France
| | - Coline Montégut
- Internal Medicine Geriatrics and Therapeutic Unit, APHM, 13009 Marseille, France
- Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France
| | - Soraya Mebarki
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Romain Geiss
- Department of Medical Oncology, Curie Institute, 92210 Saint-Cloud, France
| | - Zoé ap Thomas
- Department of Cancer Medicine, Gustave Roussy Institute, 94805 Villejuif, France
| | - Aurélien Noret
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Monica Pierro
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
| | - Capucine Baldini
- Drug Development Department, Gustave Roussy Institute, 94805 Villejuif, France
| | - Elena Paillaud
- Department of Geriatrics, Georges Pompidou European Hospital, Paris Cancer Institute CARPEM, APHP, 75015 Paris, France
- INSERM, IMRB, Clinical, Epidemiology and Ageing, Université Paris-Est Creteil, 94010 Creteil, France
| | - Frédéric Pamoukdjian
- Department of Geriatrics, Avicenne Hospital, APHP, 93000 Bobigny, France
- INSERM UMR_S942 Cardiovascular Markers in Stressed Conditions MASCOT, Sorbonne Paris Nord University, 93000 Bobigny, France
- Correspondence:
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Baş D, Arıbal ME, Vardareli E, Sönmez Ö, Oyan B, Özden BÇ, Sonkaya A. Validation of bioelectrical impedance analysis in the evaluation of body composition in patients with breast cancer. Nutr Clin Pract 2022. [PMID: 36579726 DOI: 10.1002/ncp.10947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/15/2022] [Accepted: 11/26/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The evaluation of body composition is an essential parameter for preventing obesity and sarcopenic obesity, which are prognostic factors in breast cancer. This study aims to validate the bioelectrical impedance analysis (BIA) of women who are breast cancer survivors by using the dual-energy x-ray absorptiometry (DXA) measurement method. METHODS This validation study included 104 women without metastasis between 32 and 72 years old (mean 47.03 ± 8.59) whose treatment was completed 6 months prior. Body composition analysis was performed sequentially using both measurements and when participants were hungry. RESULTS Meaningful differences were found in fat-free mass (FFM) (BIA: 46.57 ± 5.54 kg; DXA: 41.06 ± 5.11 kg), body fat percentage (%BF) (BIA: 34.28% ± 6.24%; DXA: 43.91% ± 5.58%), body fat mass (FM) (BIA: 25.37 ± 8.84 kg; DXA: 31.24 ± 9.09 kg), and lean soft tissue mass (LSTM) (BIA: 4.42 ± 5.66 kg; DXA: 38.75 ± 4.98 kg) (P < 0.001). Powerful associations for body FM and strong associations for other parameters were seen. A constant and/or proportional error was found between the two devices within the direction of strong and solid components. Compared with DXA, the BIA measurement gives a lower estimate of %BF and FM and a higher estimate of LSTM and FFM. CONCLUSIONS By the mathematical relationship between the two measurement methods, it seems possible to adapt the body composition parameters obtained from BIA of patients with breast cancer to DXA results. In the future, there will be a need to evaluate these two devices with more extensive studies.
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Affiliation(s)
- Dilşat Baş
- Health Sciences Institute, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.,Department of Nutrition and Dietetics, Acıbadem Altunizade Hospital, Istanbul, Turkey.,Department of Nutrition and Dietetics, School of Health Sciences, İstanbul Galata University, İstanbul, Turkey
| | - Mustafa Erkin Arıbal
- Department of Radiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Erkan Vardareli
- Department of Nuclear Medicine, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Özlem Sönmez
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Başak Oyan
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | | | - Alper Sonkaya
- Department of Medical Oncology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
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Miao S, Jia H, Cheng K, Hu X, Li J, Huang W, Wang R. Deep learning radiomics under multimodality explore association between muscle/fat and metastasis and survival in breast cancer patients. Brief Bioinform 2022; 23:6748489. [PMID: 36198668 DOI: 10.1093/bib/bbac432] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022] Open
Abstract
Sarcopenia is correlated with poor clinical outcomes in breast cancer (BC) patients. However, there is no precise quantitative study on the correlation between body composition changes and BC metastasis and survival. The present study proposed a deep learning radiomics (DLR) approach to investigate the effects of muscle and fat on distant metastasis and death outcomes in BC patients. Image feature extraction was performed on 4th thoracic vertebra (T4) and 11th thoracic vertebra (T11) on computed tomography (CT) image levels by DLR, and image features were combined with clinical information to predict distant metastasis in BC patients. Clinical information combined with DLR significantly predicted distant metastasis in BC patients. In the test cohort, the area under the curve of model performance on clinical information combined with DLR was 0.960 (95% CI: 0.942-0.979, P < 0.001). The patients with distant metastases had a lower pectoral muscle index in T4 (PMI/T4) than in patients without metastases. PMI/T4 and visceral fat tissue area in T11 (VFA/T11) were independent prognostic factors for the overall survival in BC patients. The pectoralis muscle area in T4 (PMA/T4) and PMI/T4 is an independent prognostic factor for distant metastasis-free survival in BC patients. The current study further confirmed that muscle/fat of T4 and T11 levels have a significant effect on the distant metastasis of BC. Appending the network features of T4 and T11 to the model significantly enhances the prediction performance of distant metastasis of BC, providing a valuable biomarker for the early treatment of BC patients.
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Affiliation(s)
- Shidi Miao
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Haobo Jia
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Ke Cheng
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Xiaohui Hu
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Jing Li
- Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Wenjuan Huang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
| | - Ruitao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, China
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