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Ozaydin D, Demir AN, Oz A, Birol A, Sulu C, Sahin S, Arslan S, Tanriover N, Gazioglu N, Kadioglu P. The relationship between temporal muscle thickness and disease activity in Cushing's disease. J Endocrinol Invest 2023; 46:2411-2420. [PMID: 37704872 DOI: 10.1007/s40618-023-02195-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE This study aimed to investigate the relationship between hypercortisolism and temporal muscle thickness (TMT) in Cushing's disease (CD). METHODS A retrospective review of medical records was conducted for patients with CD who presented to our clinic between 2012 and 2022. Biochemical data and TMT measurements from sella imaging were evaluated during diagnosis and the first postoperative year. RESULTS A total of 44 patients were included in the study, with an average age of 43.9 years, of which 38 were female. The mean TMT at the time of diagnosis was 19.07 ± 1.71 mm, with no significant difference between males and females (p = 0.097), and no correlation between the TMT and age at diagnosis (p = 0.497). There was an inverse relationship between TMT and serum cortisol levels, 24-h UFC, and midnight salivary cortisol at the time of diagnosis of CD (p < 0.05, for all). One year after surgery, TMT significantly increased in all patients compared to baseline (p < 0.001). Furthermore, patients who achieved postoperative remission had significantly higher TMT values compared to those who did not achieve remission (p = 0.043). Among the patients who achieved remission, those who achieved remission through surgery had significantly higher TMT compared to those who could not reach remission with surgery and patients who started medical treatment and achieved biochemical remission (p = 0.01). Patients with severe myopathy and sarcopenia had significantly lower TMT values than the others (p < 0.001). CONCLUSION Temporal muscle thickness was found to be associated with disease activity and disease control in Cushing's disease.
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Affiliation(s)
- D Ozaydin
- Department of Neurosurgery, Health Sciences University, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - A N Demir
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - A Oz
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - A Birol
- Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - C Sulu
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - S Sahin
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey
| | - S Arslan
- Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - N Tanriover
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - N Gazioglu
- Department of Neurosurgery, Istinye University, Istanbul, Turkey
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - P Kadioglu
- Department of Endocrinology, Metabolism, and Diabetes, Istanbul University-Cerrahpasa, 34098, Istanbul, Turkey.
- Pituitary Center, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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Haider L, Chung KK, Mangesius S, Furtner J, Ciccarelli O, Chard DT, Barkhof F. The relation of sarcopenia and disability in multiple sclerosis. Mult Scler Relat Disord 2023; 77:104855. [PMID: 37442077 DOI: 10.1016/j.msard.2023.104855] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND The relation of sarcopenia and disability in MS is unknown. OBJECTIVE To investigate the relation of temporal muscle thickness (TMT) and disability. METHODS A cohort of 132 people who presented with a clinically isolated syndrome (CIS) suggestive of MS at a mean age of 30.0 years, were prospectively followed clinically and with MRI over 30-years. TMT and expanded disability status scale (EDSS) were assessed at baseline, one- five- ten- fourteen- twenty- and thirty-year follow-up. RESULTS At 30-years, 27 participants remained classified as having had a CIS, 34 converted to relapsing remitting MS, 26 to secondary progressive MS, and 16 had died due to MS. Using linear mixed effect models with subject nested in time, greater annualized TMT-thinning was seen in individuals who developed MS (-0.04 mm/a, 95%CI: -0.07 to -0.01, p = 0.023). In those who converted to MS, a thinner TMT was reached at 14- (p = 0.008), 20- (p = 0.002) and 30-years (p< 0.001). TMT was negatively correlated with EDSS at 20-years (R=-0.18, p = 0.032) and 30-years (R-0.244, p = 0.005). Longitudinally, TMT at earlier timepoints was not predictive for 30-year clinical outcomes. CONCLUSION TMT thinning is accelerated in MS and correlated with disability in later disease stages, but is not predictive of future disability.
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Affiliation(s)
- Lukas Haider
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Austria
| | - Karen K Chung
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom.
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, Austria; Neuroimaging Core Facility, Medical University of Innsbruck, Austria
| | - Julia Furtner
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom
| | - Olga Ciccarelli
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom
| | - Declan T Chard
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom
| | - Frederik Barkhof
- NMR Research Unit, Queen Square Multiple Sclerosis Centre, University College London Institute of Neurology, United Kingdom; National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, NL, USA
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Gao Z, Chen H. Advances in the beneficial effects of nutrition on stroke-related Sarcopenia: A narrative review. Medicine (Baltimore) 2023; 102:e34048. [PMID: 37327307 PMCID: PMC10270533 DOI: 10.1097/md.0000000000034048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
Stroke is one of the most common causes of disability in adults. Sarcopenia is a syndrome characterized by progressive systemic muscle loss and functional decline. The decrease in skeletal muscle mass and muscle function throughout the body after stroke cannot be explained by neurological motor disorders due to brain injury alone, it is considered to be a secondary sarcopenia known as stroke-related sarcopenia. Mounting evidences showed that stroke-related sarcopenia might promote the occurrence and development of sarcopenia through various pathogenesis such as muscle atrophy, dysphagia, inflammation, and malnutrition, etc. At present, the main indicators used to assess malnutrition in patients with stroke-related sarcopenia include temporalis muscle thickness, calf circumference, phase angle, geriatric nutritional risk index and mini-nutritional assessment short-form, etc. Currently, there is no particularly effective method to curb its progression, but supplementation with essential amino acids, whey protein combined with vitamin D, high energy diet, avoiding Polypharmacy, as well as increasing physical activity level and reducing sedentary lifestyle may improve the malnutrition status of stroke patients, and increase the muscle mass and skeletal muscle index, further delay or even prevent the development of stroke-related sarcopenia. This article reviews the latest research progress on the characteristics, epidemiology, pathogenesis and the role of nutrition in stroke-related sarcopenia, so as to provide reference for the clinical treatment and rehabilitation of stroke-related sarcopenia.
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Affiliation(s)
- Zhiqiang Gao
- School of Public Health, Hubei University of Medicine, Shiyan, China
| | - Hongxia Chen
- Institute of Biomedical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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Namgung HG, Hong S, Choi YA. Association of Temporalis Muscle Mass with Early Cognitive Impairment in Older Patients with Acute Ischemic Stroke. J Clin Med 2023; 12:4071. [PMID: 37373767 DOI: 10.3390/jcm12124071] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The prognostic value of temporal muscle mass has been studied in various neurological disorders. Herein, we investigated the association between temporal muscle mass and early cognitive function in patients with acute ischemic stroke. This study included 126 patients with acute cerebral infarction aged ≥65 years. Temporal muscle thickness (TMT) was measured using T2-weighted brain magnetic resonance imaging at admission for acute stroke. Within 2 weeks of stroke onset, skeletal mass index (SMI) and cognitive function were assessed using bioelectrical impedance analysis and the Korean version of the Montreal Cognitive Assessment (MoCA), respectively. Pearson's correlation analyzed the correlation between TMT and SMI, and multiple linear regression analyzed independent predictors of early post-stroke cognitive function. TMT and SMI were significantly positively correlated (R = 0.36, p < 0.001). After adjusting for covariates, TMT was an independent predictor of early post-stroke cognitive function, stratified by the MoCA score (β = 1.040, p = 0.017), age (β = -0.27, p = 0.006), stroke severity (β = -0.298, p = 0.007), and education level (β = 0.38, p = 0.008). TMT may be used as a surrogate marker for evaluating skeletal muscle mass because it is significantly associated with post-stroke cognitive function during the acute phase of ischemic stroke; therefore, TMT may help detect older patients at a high risk of early post-stroke cognitive impairment.
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Affiliation(s)
- Ho-Geon Namgung
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seungho Hong
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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Chen M, Wang X, Han M, Li Y, Yu N, Long X, Chen W. Temporal and periorbital depressions identified by 3D images are correlated with malnutrition phenotypes in cancer patients: A pilot study. Front Nutr 2023; 10:1115079. [PMID: 36992909 PMCID: PMC10042485 DOI: 10.3389/fnut.2023.1115079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/10/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundPrompt diagnosis of malnutrition and appropriate interventions can substantially improve the prognosis of patients with cancer; however, it is difficult to unify the tools for screening malnutrition risk. 3D imaging technology has been emerging as an approach to assisting in the diagnosis of diseases, and we designed this study to explore its application value in identifying the malnutrition phenotype and evaluating nutrition status.MethodsHospitalized patients treating with maintenance chemotherapy for advanced malignant tumor of digestive system were recruited from the Department of Oncology, whose NRS 2002 score > 3. Physical examination and body composition data of patients at risk for malnutrition were analyzed by physicians trained to complete a subjective global assessment. The facial depression index was recognized using the Antera 3D® system, temporal and periorbital depression indexes were acquired using the companion software Antera Pro. This software captures quantitative data of depression volume, affected area, and maximum depth of temporal and periorbital concave areas.ResultsA total of 53 inpatients with malnutrition-related indicators were included. The volume of temporal depression was significantly negatively correlated with upper arm circumference (r = −0.293, p = 0.033) and calf circumference (r = −0.285, p = 0.038). The volume and affected area of periorbital depression were significantly negatively correlated with fat mass index (r = −0.273, p = 0.048 and r = −0.304, p = 0.026, respectively) and percent body fat (r = −0.317, p = 0.021 and r = −0.364, p = 0.007, respectively). The volume and affected area of temporal depression in patients with muscle loss phenotype (low arm circumference/low calf circumference/low handgrip strength/low fat-free mass index) were significantly higher than those in patients without muscle loss. Moreover, patients with fat mass loss phenotype (low fat mass index) showed a significant increase in the volume and affected area of periorbital depression.ConclusionThe facial temporal region, and periorbital depression indicators extracted by 3D image recognition technology were significantly associated with the phenotype of malnutrition-related muscle and fat loss and showed a trend of grade changes in the population of different subjective global assessment nutritional classifications.
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Affiliation(s)
- Moxi Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xue Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Meifen Han
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yunzhu Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Nanze Yu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Xiao Long
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
- Xiao Long,
| | - Wei Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- *Correspondence: Wei Chen,
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Kara E, Şahutoğlu T, Demirbaş S, Beyazal M. Temporal muscle thickness predicts mortality in prevalent hemodialysis patients. Rev Assoc Med Bras (1992) 2022; 68:1715-1720. [PMID: 36449799 PMCID: PMC9779950 DOI: 10.1590/1806-9282.20220844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Ultrasonographic temporal muscle thickness measurement has recently emerged as a promising method of nutritional assessment in various conditions; hence, we aimed to determine the relationship between temporal muscle thickness and mortality in prevalent hemodialysis patients. METHODS Adult patients who were on a regular in-center hemodialysis program for ≥3 months were included, and patients with severe nonrenal organ failure or any recent significant disease inception were excluded. Baseline demographic; clinical, laboratory, and anthropometric data, including malnutrition inflammation score; and outcomes data were collected using a standardized form. RESULTS A total of 60 patients (32 males, diabetes prevalence: 26.6%) who met the eligibility criteria participated in the study, with a mean follow-up of 33.3±11.5 months, a median age of 66.5 (interquartile range 52.7-74) years, time on hemodialysis of 36 months, and a body mass index of 25.9 kg/m². Infections and cardiovascular events were the most common causes of overall mortality that occurred in 41.6% of the patients. Temporal muscle thickness was significantly lower in nonsurvivors (8.8 vs. 10.6 mm, p<0.001). Multivariate Cox regression analysis involving age, albumin, spKt/V, and malnutrition inflammation score revealed that temporal muscle thickness was a significant predictor of mortality (hazard ratio=0.740, p=0.035). Receiver operating characteristic curve analysis has shown 68% of sensitivity and 81.8% of specificity for a cutoff value of 9.4 mm (p<0.001). Temporal muscle thickness was weakly or mildly correlated with hemodialysis vintage, body mass index, albumin, and malnutrition inflammation score and moderately correlated with age (r=-0.536, p<0.001). CONCLUSION Ultrasonographic temporal muscle thickness has been found as a significant predictor of mortality in prevalent hemodialysis patients. Temporal muscle thickness could be a novel marker of nutritional status and predictor of mortality; hence, further studies are warranted.
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Affiliation(s)
- Ekrem Kara
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Nephrology – Rize, Turkey.,Corresponding author:
| | - Tuncay Şahutoğlu
- Mehmet Akif Inan Training and Research Hospital, Department of Nephrology – Sanlıurfa, Turkey
| | - Sibel Demirbaş
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Internal Medicine – Rize, Turkey
| | - Mehmet Beyazal
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Radiology – Rize, Turkey
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Diagnostic Utility of Temporal Muscle Thickness as a Monitoring Tool for Muscle Wasting in Neurocritical Care. Nutrients 2022; 14:nu14214498. [PMID: 36364761 PMCID: PMC9654352 DOI: 10.3390/nu14214498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022] Open
Abstract
Temporalis muscle (TM) atrophy has emerged as a potential biomarker for muscle wasting. However, its diagnostic utility as a monitoring tool in intensive care remains uncertain. Hence, the objective of this study was to evaluate the diagnostic value of sequential ultrasound- and computed tomography (CT)-based measurements of TM thickness (TMT). With a prospective observational design, we included 40 patients without preexisting sarcopenia admitted to a neurointensive care unit. TMT measurements, performed upon admission and serially every 3−4 days, were correlated with rectus femoris muscle thickness (RFT) ultrasound measurements. Interrater reliability was assessed by Bland Altmann plots and intraclass correlation coefficient (ICC). Analysis of variance was performed in subgroups to evaluate differences in the standard error of measurement (SEM). RFT decline was paralleled by ultrasound- as well as CT-based TMT measurements (TMT to RFT: r = 0.746, p < 0.001; CT-based TMT to ultrasound-based RFT: r = 0.609, p < 0.001). ICC was 0.80 [95% CI 0.74, 0.84] for ultrasound-based assessment and 0.90 [95% CI 0.88, 0.92] for CT-based TMT measurements. Analysis of variance for BMI, Heckmatt score, fluid balance, and agitation showed no evidence of measurement errors in these subgroups. This study demonstrates the clinical feasibility and utility of ultrasound- and CT-based TMT measurements for the assessment of muscle wasting.
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Katsuki M, Kakizawa Y, Nishikawa A, Yamamoto Y, Uchiyama T, Agata M, Wada N, Kawamura S, Koh A. Temporal Muscle and Stroke—A Narrative Review on Current Meaning and Clinical Applications of Temporal Muscle Thickness, Area, and Volume. Nutrients 2022; 14:nu14030687. [PMID: 35277046 PMCID: PMC8840759 DOI: 10.3390/nu14030687] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Evaluating muscle mass and function among stroke patients is important. However, evaluating muscle volume and function is not easy due to the disturbances of consciousness and paresis. Temporal muscle thickness (TMT) has been introduced as a novel surrogate marker for muscle mass, function, and nutritional status. We herein performed a narrative literature review on temporal muscle and stroke to understand the current meaning of TMT in clinical stroke practice. Methods: The search was performed in PubMed, last updated in October 2021. Reports on temporal muscle morphomics and stroke-related diseases or clinical entities were collected. Results: Four studies reported on TMT and subarachnoid hemorrhage, two studies on intracerebral hemorrhage, two studies on ischemic stroke, two studies on standard TMT values, and two studies on nutritional status. TMT was reported as a prognostic factor for several diseases, a surrogate marker for skeletal muscle mass, and an indicator of nutritional status. Computed tomography, magnetic resonance imaging, and ultrasonography were used to measure TMT. Conclusions: TMT is gradually being used as a prognostic factor for stroke or a surrogate marker for skeletal muscle mass and nutritional status. The establishment of standard methods to measure TMT and large prospective studies to further investigate the relationship between TMT and diseases are needed.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
| | - Yukinari Kakizawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
- Correspondence:
| | - Akihiro Nishikawa
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Yasunaga Yamamoto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Toshiya Uchiyama
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Masahiro Agata
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Naomichi Wada
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-8510, Nagano, Japan; (M.K.); (A.N.); (Y.Y.); (T.U.); (M.A.); (N.W.)
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan; (S.K.); (A.K.)
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Furtner J, Weller M, Weber M, Gorlia T, Nabors B, Reardon DA, Tonn JC, Stupp R, Preusser M. Temporal muscle thickness as a prognostic marker in newly diagnosed glioblastoma patients: translational imaging analysis of the CENTRIC EORTC 26071-22072 and CORE trials. Clin Cancer Res 2021; 28:129-136. [PMID: 34667022 DOI: 10.1158/1078-0432.ccr-21-1987] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/20/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the prognostic relevance of temporal muscle thickness (TMT) as a surrogate parameter of skeletal muscle status in patients with newly diagnosed glioblastoma. METHODS We assessed TMT in cranial magnetic resonance images (MRI) of 755 patients enrolled in the CENTRIC EORTC 26071-22072 study (n=508) and CORE study (n=247). We used predefined sex-specific TMT cutoff values to categorize "patients at risk of sarcopenia" and "patients with normal muscle status" at baseline. Furthermore, we categorized patients according to the extent of TMT loss over time. Associations with progression-free survival (PFS) and overall survival (OS) were evaluated using the Cox model adjusted for other exploratory variables. RESULTS Patients at risk of sarcopenia (CENTRIC; n=158/508, 31.1%; CORE; n=87/247, 35.2%) at baseline had significantly higher risk of progression and death than patients with normal muscle status in both study cohorts (CENTRIC: PFS=HR 0.16, 95% CI: 0.12, 0.21, p<0.001; OS=HR 0.341, 95% CI: 0.27, 0.44, p < 0.001; CORE: PFS=HR 0.29, 95% CI: 0.21, 0.39, p<0.001; OS=HR 0.365, 95% CI: 0.27, 0.49, p<0.001). Similar results were obtained in multivariate Cox models adjusted for other important prognostic parameters. The extent of TMT loss over time showed a significant inverse correlation with median OS times in patients at risk for sarcopenia (CENTRIC: p<0.001, CORE: p=0.005), but not in patients with normal baseline muscle mass (CENTRIC: p=0.538, CORE: p=0.28). CONCLUSION TMT identifies ambulatory patients with newly diagnosed glioblastoma at risk for progressive sarcopenia and adverse outcomes. Early intervention may prevent skeletal muscle loss and improve patient outcome.
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Affiliation(s)
- Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
| | - Michael Weller
- Laboratory of Molecular Neuro-Oncology, Department of Neurology, University Hospital and University of Zurich
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna
| | - Thierry Gorlia
- Data Center, European Organisation for Research and Treatment of Cancer
| | - Burt Nabors
- Department of Neurology, University of Alabama at Birmingham
| | | | | | - Roger Stupp
- Malnati Brain Tumor Institute and Lurie Cancer Center, Northwestern University, Feinberg School of Medicine
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