Sarcopenia and systemic inflammation are associated with decreased survival after cytoreductive nephrectomy for metastatic renal cell carcinoma
Background: This study was aimed at assessing the associations of sarcopenia, muscle density, adiposity, and inflammation with overall survival (OS) after cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma.
Methods: In all, 158 patients undergoing CN from 2001 to 2014 had digitized preoperative imaging for tissue segmentation via Slice-O-Matic software (version 5.0) at the mid-L3 level. The skeletal muscle index was calculated with the skeletal muscle area (cm2 ) normalized for height (m2 ), and the skeletal muscle density (SMD) was calculated with average Hounsfield units. Adiposity was measured with the cross-sectional area (cm2 ) of visceral, subcutaneous, and intramuscular adiposity compartments and was similarly normalized for height. The average fat density was obtained in Hounsfield units. OS was estimated with the Kaplan-Meier method. Associations between body composition, inflammation metrics, and relevant clinicopathology and OS were assessed with univariable and multivariate Cox analyses.
Results: Seventy-six of the 158 patients (48%) were sarcopenic. Sarcopenia was associated with elevated neutrophil to lymphocyte ratios (NLRs; P = .02), increased age (P = .001), lower body mass indices (P = .009), greater modified Motzer scores (P = .019), and lower SMD (P = .006). The median OS was 15.0 and 29.4 months for sarcopenic and nonsarcopenic patients, respectively (P = .04). Elevated inflammation (NLR or C-reactive protein), in addition to sarcopenia, was independently associated with OS, with an elevated NLR ≥ 3.5 and sarcopenia associated with the poorest OS at 10.2 months. No associations were observed between measurements of muscle density or adiposity and OS.
Conclusions: Sarcopenia and measures of high systemic inflammation are additively associated with inferior OS after CN and may be of use in preoperative risk stratification.
Lay summary: Body composition and sarcopenia (a deficiency in skeletal musculature) have been shown to affect outcomes in cancer. We found that sarcopenic patients had poor survival in comparison with nonsarcopenic patients in the setting of metastatic renal cell carcinoma (mRCC). Patients with both elevated inflammation and sarcopenia had the poorest survival. Sarcopenia is an objective measure of nutrition that can assist in therapeutic counseling and decision-making for individualized treatment in mRCC.
Amir Ishaq Khan
Sarah P Psutka
Dattatraya H Patil
Gordon Hong
Milton A Williams
Mehmet A Bilen
Aarti Sekhar
Haydn T Kissick
Vikram M Narayan
Shreyas S Joshi
Kenneth Ogan
Viraj A Master
Cancer
. 2022 Jun 1;128(11):2073-2084. doi: 10.1002/cncr.34174. Epub 2022 Mar 14.
2022
English
Early Evidence of Low Bone Density and Decreased Serotonergic Synthesis in the Dorsal Raphe of a Tauopathy Model of Alzheimer's Disease.
Female; Male; Animals; Mice; *Alzheimer's disease; Body Weight; Body Composition; Age Factors; Body Weight/genetics; Phosphorylation; Bone Density/*physiology; *Alzheimer Disease/complications/genetics/pathology; *bone density; *microtubule-associated protein; *serotonin; *tau proteins; *tauopathies; Body Composition/genetics; Bone Diseases/*etiology; Dorsal Raphe Nucleus/*pathology; Neurons/metabolism/pathology; Serotonin/*metabolism; tau Proteins/*genetics/metabolism; Tauopathies/complications/genetics; Tryptophan Hydroxylase/metabolism; Biological; Models; Inbred C57BL; Animal; Disease Models; Transgenic; Nerve Tissue Proteins; Neurodegenerative Diseases; Animal Studies; Alzheimer's Disease; Bone Density – Physiology; Nerve Tissue Proteins – Metabolism; Neurodegenerative Diseases – Complications; Alzheimer's Disease – Complications; Alzheimer's Disease – Pathology; Bone Diseases – Etiology; Brain Stem – Pathology; Neurons – Metabolism; Neurons – Pathology; Oxidoreductases – Metabolism; Serotonin – Metabolism
Reduced bone mineral density (BMD) and its clinical sequelae, osteoporosis, occur at a much greater rate in patients with Alzheimer's disease (AD), often emerging early in the disease before significant cognitive decline is seen. Reduced BMD translates to increased bone fracture risk, decreased quality of life, and increased mortality for AD patients. However, the mechanism responsible for this observation is unclear. We hypothesize that bone loss is an additional component of an AD prodrome-changes that emerge prior to dementia and are mediated by dysfunction of the central serotonergic pathways. We characterized the skeletal phenotype of htau mice that express human forms of the microtubule-associated protein tau that become pathologically hyperphosphorylated in AD. Using radiographic densitometry, we measured BMD in female and male htau mice from 2-6 months of age-time-points prior to the presence of significant tauopathy in the hippocampal/entorhinal regions characteristic of this model. We found a significantly reduced BMD phenotype in htau mice that was most pronounced in males. Using western blotting and immunofluorescence, we showed overall reduced tryptophan hydroxylase (TPH) protein in htau brainstem and a 70% reduction in
Dengler-Crish Christine M; Smith Matthew A; Wilson Gina N
Journal of Alzheimer's disease : JAD
2017
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3233/JAD-160658" target="_blank" rel="noreferrer noopener">10.3233/JAD-160658</a>
Body Weight And Composition Changes In Ovarian Cancer Patients During Adjuvant Chemotherapy
body composition; breast cancer; chemotherapy; gain; Obstetrics & Gynecology; Oncology; ovarian cancer; weight; women
Gil K M; Frasure H E; Hopkins M P; Jenison E L; Von Gruenigen V E
Gynecologic Oncology
2006
2006-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.ygyno.2006.03.005" target="_blank" rel="noreferrer noopener">10.1016/j.ygyno.2006.03.005</a>
Low thigh muscle mass is associated with coronary artery stenosis among
*Computed Tomography Angiography; *Tomography; Aged; Atherosclerotic; Body Composition; Chi-Square Distribution; Coronary Angiography/*methods; Coronary Artery Disease/*diagnostic imaging/epidemiology/pathology; Coronary artery stenosis; Coronary atherosclerosis; Coronary Stenosis/*diagnostic imaging/epidemiology/pathology; Coronary Vessels/*diagnostic imaging/pathology; Cross-Sectional Studies; HIV Infections/diagnosis/*epidemiology; HIV-infection; Humans; Male; Middle Aged; Multivariate Analysis; Muscle; Muscle mass; Odds Ratio; Plaque; Predictive Value of Tests; Prevalence; Prospective Studies; Risk Factors; Sarcopenia; Sarcopenia/*diagnostic imaging/epidemiology/physiopathology; Skeletal/*diagnostic imaging/physiopathology; Thigh; United States/epidemiology; X-Ray Computed
BACKGROUND: HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown. METHODS: We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010-2013. Of these, 379 also underwent coronary CT angiography for non-calcified coronary plaque (NCP) and obstructive coronary stenosis \textgreater/=50%. Multivariable-adjusted Poisson regression was used to estimate prevalence risk ratios of associations between low muscle mass (\textless20th percentile of the
Tibuakuu Martin; Zhao Di; Saxena Ankita; Brown Todd T; Jacobson Lisa P; Palella Frank J Jr; Witt Mallory D; Koletar Susan L; Margolick Joseph B; Guallar Eliseo; Korada Sai Krishna C; Budoff Matthew J; Post Wendy S; Michos Erin D
Journal of cardiovascular computed tomography
2018
2018-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jcct.2018.01.007" target="_blank" rel="noreferrer noopener">10.1016/j.jcct.2018.01.007</a>