Hiroki Ishihara1, Tsunenori Kondo2, Kenji Omae1, Toshio Takagi1, Jumpei Iizuka1, Hirohito Kobayashi1, Kazunari Tanabe1. 1. Department of Urology, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan, 162-8666. 2. Department of Urology, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan, 162-8666. tkondo@kc.twmu.ac.jp.
Abstract
BACKGROUND: Cancer cachexia is associated with patient outcomes. OBJECTIVE: The objective was to evaluate the effect of cachexia on survival among patients with metastatic renal cell carcinoma (mRCC) who had received first-line sunitinib treatment. PATIENTS AND METHODS: Seventy-one patients were retrospectively evaluated. Sarcopenia was diagnosed using sex-specific cut-offs for skeletal muscle index (measured using pre-treatment computed tomography) that were adjusted for body mass index. The modified Glasgow prognostic score (mGPS) was measured using C-reactive protein (CRP) and albumin levels (mGPS 2: CRP >1.0 mg/dL and albumin <3.5 g/dL; mGPS 1: CRP >1.0 mg/dL; mGPS 0: CRP ≤1.0 mg/dL). Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazard models. RESULTS: Forty-five patients (63.4 %) had sarcopenia, with 53 (74.6 %), ten (14.1 %), and eight (11.3 %) patients having an mGPS of 0, 1, and 2, respectively. Sarcopenia was associated with significantly inferior PFS and OS, compared to non-sarcopenic patients (PFS: 7.6 vs. 18.2 months, p = 0.0004; OS: 22.3 months vs. not reached, p = 0.0019). Higher mGPS was associated with inferior PFS and OS (mGPS 0, 1, and 2: PFS = 11.5, 10.9, and 4.12 months, p < 0.0001; OS = 47.2, not reached, and 5.28 months, p < 0.0001; respectively). Sarcopenia was an independent predictor of shorter PFS (p = 0.0163), and mGPS was an independent predictor of shorter OS (p = 0.0012). CONCLUSION: Sarcopenia and mGPS can predict outcomes among patients with mRCC who are receiving first-line sunitinib treatment.
BACKGROUND:Cancer cachexia is associated with patient outcomes. OBJECTIVE: The objective was to evaluate the effect of cachexia on survival among patients with metastatic renal cell carcinoma (mRCC) who had received first-line sunitinib treatment. PATIENTS AND METHODS: Seventy-one patients were retrospectively evaluated. Sarcopenia was diagnosed using sex-specific cut-offs for skeletal muscle index (measured using pre-treatment computed tomography) that were adjusted for body mass index. The modified Glasgow prognostic score (mGPS) was measured using C-reactive protein (CRP) and albumin levels (mGPS 2: CRP >1.0 mg/dL and albumin <3.5 g/dL; mGPS 1: CRP >1.0 mg/dL; mGPS 0: CRP ≤1.0 mg/dL). Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazard models. RESULTS: Forty-five patients (63.4 %) had sarcopenia, with 53 (74.6 %), ten (14.1 %), and eight (11.3 %) patients having an mGPS of 0, 1, and 2, respectively. Sarcopenia was associated with significantly inferior PFS and OS, compared to non-sarcopenicpatients (PFS: 7.6 vs. 18.2 months, p = 0.0004; OS: 22.3 months vs. not reached, p = 0.0019). Higher mGPS was associated with inferior PFS and OS (mGPS 0, 1, and 2: PFS = 11.5, 10.9, and 4.12 months, p < 0.0001; OS = 47.2, not reached, and 5.28 months, p < 0.0001; respectively). Sarcopenia was an independent predictor of shorter PFS (p = 0.0163), and mGPS was an independent predictor of shorter OS (p = 0.0012). CONCLUSION:Sarcopenia and mGPS can predict outcomes among patients with mRCC who are receiving first-line sunitinib treatment.
Authors: Samantha J Cushen; Derek G Power; Min Y Teo; Peter MacEneaney; Michael M Maher; Ray McDermott; Kathleen O'Sullivan; Aoife M Ryan Journal: Am J Clin Oncol Date: 2017-02 Impact factor: 2.339
Authors: Sami Antoun; Emilie Lanoy; Roberto Iacovelli; Laurence Albiges-Sauvin; Yohann Loriot; Mansouriah Merad-Taoufik; Karim Fizazi; Mario di Palma; Vickie E Baracos; Bernard Escudier Journal: Cancer Date: 2013-06-25 Impact factor: 6.860
Authors: A S Koo; C Armstrong; B Bochner; T Shimabukuro; C L Tso; J B deKernion; A Belldegrum Journal: Cancer Immunol Immunother Date: 1992 Impact factor: 6.968
Authors: Robert J Motzer; Thomas E Hutson; Piotr Tomczak; M Dror Michaelson; Ronald M Bukowski; Olivier Rixe; Stéphane Oudard; Sylvie Negrier; Cezary Szczylik; Sindy T Kim; Isan Chen; Paul W Bycott; Charles M Baum; Robert A Figlin Journal: N Engl J Med Date: 2007-01-11 Impact factor: 91.245
Authors: Carla M Prado; Sarah A Purcell; Carolyn Alish; Suzette L Pereira; Nicolaas E Deutz; Daren K Heyland; Bret H Goodpaster; Kelly A Tappenden; Steven B Heymsfield Journal: Ann Med Date: 2018-09-12 Impact factor: 4.709