Emily van Seventer1, J Peter Marquardt2, Amelie S Troschel2, Till D Best2,3, Nora Horick4, Chinenye Azoba1, Richard Newcomb1, Eric J Roeland1, Michael Rosenthal5,6, Christopher P Bridge7, Joseph A Greer8, Areej El-Jawahri1, Jennifer Temel1, Florian J Fintelmann2, Ryan D Nipp1. 1. 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and. 2. 2Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 3. 3Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany; and. 4. 4Department of Statistics, Massachusetts General Hospital and Harvard Medical School. 5. 5Dana-Farber Cancer Institute. 6. 6Department of Radiology, Brigham and Women's Hospital. 7. 7Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science, and. 8. 8Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Low muscle mass (quantity) is common in patients with advanced cancer, but little is known about muscle radiodensity (quality). We sought to describe the associations of muscle mass and radiodensity with symptom burden, healthcare use, and survival in hospitalized patients with advanced cancer. METHODS: We prospectively enrolled hospitalized patients with advanced cancer from September 2014 through May 2016. Upon admission, patients reported their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used CT scans performed per routine care within 45 days before enrollment to evaluate muscle mass and radiodensity. We used regression models to examine associations of muscle mass and radiodensity with patients' symptom burden, healthcare use (hospital length of stay and readmissions), and survival. RESULTS: Of 1,121 patients enrolled, 677 had evaluable muscle data on CT (mean age, 62.86 ± 12.95 years; 51.1% female). Older age and female sex were associated with lower muscle mass (age: B, -0.16; P<.001; female: B, -6.89; P<.001) and radiodensity (age: B, -0.33; P<.001; female: B, -1.66; P=.014), and higher BMI was associated with higher muscle mass (B, 0.58; P<.001) and lower radiodensity (B, -0.61; P<.001). Higher muscle mass was significantly associated with improved survival (hazard ratio, 0.97; P<.001). Notably, higher muscle radiodensity was significantly associated with lower ESAS-Physical (B, -0.17; P=.016), ESAS-Total (B, -0.29; P=.002), PHQ-4-Depression (B, -0.03; P=.006), and PHQ-4-Anxiety (B, -0.03; P=.008) symptoms, as well as decreased hospital length of stay (B, -0.07; P=.005), risk of readmission or death in 90 days (odds ratio, 0.97; P<.001), and improved survival (hazard ratio, 0.97; P<.001). CONCLUSIONS: Although muscle mass (quantity) only correlated with survival, we found that muscle radiodensity (quality) was associated with patients' symptoms, healthcare use, and survival. These findings underscore the added importance of assessing muscle quality when seeking to address adverse muscle changes in oncology.
BACKGROUND: Low muscle mass (quantity) is common in patients with advanced cancer, but little is known about muscle radiodensity (quality). We sought to describe the associations of muscle mass and radiodensity with symptom burden, healthcare use, and survival in hospitalized patients with advanced cancer. METHODS: We prospectively enrolled hospitalized patients with advanced cancer from September 2014 through May 2016. Upon admission, patients reported their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used CT scans performed per routine care within 45 days before enrollment to evaluate muscle mass and radiodensity. We used regression models to examine associations of muscle mass and radiodensity with patients' symptom burden, healthcare use (hospital length of stay and readmissions), and survival. RESULTS: Of 1,121 patients enrolled, 677 had evaluable muscle data on CT (mean age, 62.86 ± 12.95 years; 51.1% female). Older age and female sex were associated with lower muscle mass (age: B, -0.16; P<.001; female: B, -6.89; P<.001) and radiodensity (age: B, -0.33; P<.001; female: B, -1.66; P=.014), and higher BMI was associated with higher muscle mass (B, 0.58; P<.001) and lower radiodensity (B, -0.61; P<.001). Higher muscle mass was significantly associated with improved survival (hazard ratio, 0.97; P<.001). Notably, higher muscle radiodensity was significantly associated with lower ESAS-Physical (B, -0.17; P=.016), ESAS-Total (B, -0.29; P=.002), PHQ-4-Depression (B, -0.03; P=.006), and PHQ-4-Anxiety (B, -0.03; P=.008) symptoms, as well as decreased hospital length of stay (B, -0.07; P=.005), risk of readmission or death in 90 days (odds ratio, 0.97; P<.001), and improved survival (hazard ratio, 0.97; P<.001). CONCLUSIONS: Although muscle mass (quantity) only correlated with survival, we found that muscle radiodensity (quality) was associated with patients' symptoms, healthcare use, and survival. These findings underscore the added importance of assessing muscle quality when seeking to address adverse muscle changes in oncology.
Authors: Christopher P Bridge; Till D Best; Maria M Wrobel; J Peter Marquardt; Kirti Magudia; Cylen Javidan; Jonathan H Chung; Jayashree Kalpathy-Cramer; Katherine P Andriole; Florian J Fintelmann Journal: Radiol Artif Intell Date: 2022-01-05
Authors: Ella Mi; Radvile Mauricaite; Lillie Pakzad-Shahabi; Jiarong Chen; Andrew Ho; Matt Williams Journal: Br J Cancer Date: 2021-11-30 Impact factor: 7.640
Authors: Haixiao Wu; Shu Li; Yile Lin; Jun Wang; Vladimir P Chekhonin; Karl Peltzer; Vladimir P Baklaushev; Kirellos Said Abbas; Jin Zhang; Huiyang Li; Chao Zhang Journal: Front Nutr Date: 2022-07-28
Authors: J Peter Marquardt; Eric J Roeland; Emily E Van Seventer; Till D Best; Nora K Horick; Ryan D Nipp; Florian J Fintelmann Journal: J Cachexia Sarcopenia Muscle Date: 2021-11-02 Impact factor: 12.910