Olivier Q Groot1, Michiel E R Bongers1, Colleen G Buckless2, Peter K Twining1, Neal D Kapoor1, Stein J Janssen3, Joseph H Schwab1, Martin Torriani2, Miriam A Bredella2. 1. Department of Orthopaedic Surgery-Orthopaedic Oncology Service, Massachusetts General Hospital-Harvard Medical School, Boston, Massachusetts, USA. 2. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Center-University of Amsterdam Meibergdreef, Amsterdam, The Netherlands.
Abstract
BACKGROUND AND OBJECTIVES: Body composition measurements using computed tomography (CT) may serve as imaging biomarkers of survival in patients with and without cancer. This study assesses whether body composition measurements obtained on abdominal CTs are independently associated with 90-day and 1-year mortality in patients with long-bone metastases undergoing surgery. METHODS: This single institutional retrospective study included 212 patients who had undergone surgery for long-bone metastases and had a CT of the abdomen within 90 days before surgery. Quantification of cross-sectional areas (CSA) and CT attenuation of abdominal subcutaneous adipose tissue, visceral adipose tissue, and paraspinous and abdominal muscles were performed at L4. Multivariate Cox proportional-hazards analyses were performed. RESULTS: Sarcopenia was independently associated with 90-day mortality (hazard ratio [HR] = 1.87; 95% confidence interval [CI] = 1.11-3.16; p = 0.019) and 1-year mortality (HR = 1.50; 95% CI = 1.02-2.19; p = 0.038) in multivariate analysis while controlling for clinical variables such as primary tumors, comorbidities, and chemotherapy. Abdominal fat CSAs and muscle attenuation were not associated with mortality. CONCLUSIONS: The presence of sarcopenia assessed by CT is predictive of 90-day and 1-year mortality in patients undergoing surgery for long-bone metastases. This body composition measurement can be used as novel imaging biomarker supplementing existing prognostic tools to optimize patient selection for surgery and improve shared decision making.
BACKGROUND AND OBJECTIVES: Body composition measurements using computed tomography (CT) may serve as imaging biomarkers of survival in patients with and without cancer. This study assesses whether body composition measurements obtained on abdominal CTs are independently associated with 90-day and 1-year mortality in patients with long-bone metastases undergoing surgery. METHODS: This single institutional retrospective study included 212 patients who had undergone surgery for long-bone metastases and had a CT of the abdomen within 90 days before surgery. Quantification of cross-sectional areas (CSA) and CT attenuation of abdominal subcutaneous adipose tissue, visceral adipose tissue, and paraspinous and abdominal muscles were performed at L4. Multivariate Cox proportional-hazards analyses were performed. RESULTS: Sarcopenia was independently associated with 90-day mortality (hazard ratio [HR] = 1.87; 95% confidence interval [CI] = 1.11-3.16; p = 0.019) and 1-year mortality (HR = 1.50; 95% CI = 1.02-2.19; p = 0.038) in multivariate analysis while controlling for clinical variables such as primary tumors, comorbidities, and chemotherapy. Abdominal fat CSAs and muscle attenuation were not associated with mortality. CONCLUSIONS: The presence of sarcopenia assessed by CT is predictive of 90-day and 1-year mortality in patients undergoing surgery for long-bone metastases. This body composition measurement can be used as novel imaging biomarker supplementing existing prognostic tools to optimize patient selection for surgery and improve shared decision making.
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Authors: Olivier Q Groot; Michiel E R Bongers; Colleen G Buckless; Peter K Twining; Neal D Kapoor; Stein J Janssen; Joseph H Schwab; Martin Torriani; Miriam A Bredella Journal: J Surg Oncol Date: 2022-01-13 Impact factor: 2.885
Authors: Stein J Janssen; Joost T P Kortlever; John E Ready; Kevin A Raskin; Marco L Ferrone; Francis J Hornicek; Santiago A Lozano-Calderon; Joseph H Schwab Journal: J Am Acad Orthop Surg Date: 2016-07 Impact factor: 3.020
Authors: Quirina C B S Thio; Aditya V Karhade; Bas JJ Bindels; Paul T Ogink; Jos A M Bramer; Marco L Ferrone; Santiago Lozano Calderón; Kevin A Raskin; Joseph H Schwab Journal: Clin Orthop Relat Res Date: 2020-02 Impact factor: 4.755
Authors: Olivier Q Groot; Michiel E R Bongers; Colleen G Buckless; Peter K Twining; Neal D Kapoor; Stein J Janssen; Joseph H Schwab; Martin Torriani; Miriam A Bredella Journal: J Surg Oncol Date: 2022-01-13 Impact factor: 2.885