Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions

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Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

10.21203/rs.2.23302/v1 ◽

2020 ◽

Author(s):

Romain Mallet ◽

Romain Modzelewski ◽

Justine Lequesne ◽

Pierre Decazes ◽

Hugues Auvray ◽

...

Keyword(s):

Skeletal Muscle ◽

Cancer Patients ◽

Oesophageal Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Locally Advanced ◽

Ct Images ◽

Pet Ct ◽

Nutritional Risk Index ◽

Fdg Pet Ct

Abstract Background Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer patients treated by curative-intent chemo-radiotherapy. Methods The clinical, nutritional, anthropometric, and functional-imaging ( 18 FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution (RTEP3). The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3 rd . lumbar vertebra level and divided by the patient’s squared height (SML3/h 2 ) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability. Results Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that reduced SMI (Hazard Ratio 0.948 [0.919 - 0.978] and male sex (2.977 [1.427 - 6.213] were significantly associated to decreased survival. Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm 2 /m 2 . In women, the AUC was 0.65 (p=0.19). Conclusion Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18 FDG-PET/CT acquisitions

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FDG-PET/CT as prognostic factor and surveillance tool for postoperative radiation recurrence in locally advanced head and neck cancer

Radiation Oncology Journal ◽

10.3857/roj.2011.29.4.243 ◽

2011 ◽

Vol 29 (4) ◽

pp. 243 ◽

Cited By ~ 24

Author(s):

Giwon Kim ◽

Yeon Sil Kim ◽

Eun Ji Han ◽

Ie Ryung Yoo ◽

Jin-Ho Song ◽

...

Keyword(s):

Head And Neck Cancer ◽

Prognostic Factor ◽

Head And Neck ◽

Neck Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Advanced Head ◽

Postoperative Radiation ◽

Pet Ct ◽

Fdg Pet Ct

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Uncommon isolated distant subcutaneous tissue and skeletal muscle metastasis from oesophageal cancer diagnosed by 18 F-FDG PET/CT

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) ◽

10.1016/j.remnie.2015.10.011 ◽

2016 ◽

Vol 35 (1) ◽

pp. 38-41 ◽

Cited By ~ 1

Author(s):

M.L. Domínguez ◽

J.I. Rayo ◽

J. Serrano ◽

J.R. Infante ◽

L. García ◽

...

Keyword(s):

Skeletal Muscle ◽

Oesophageal Cancer ◽

Fdg Pet ◽

Subcutaneous Tissue ◽

Skeletal Muscle Metastasis ◽

Pet Ct ◽

Muscle Metastasis ◽

Fdg Pet Ct

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Total Lesion Glycolysis Using 18F-FDG PET/CT as a Prognostic Factor for Locally Advanced Esophageal Cancer

Journal of Korean Medical Science ◽

10.3346/jkms.2016.31.1.39 ◽

2016 ◽

Vol 31 (1) ◽

pp. 39 ◽

Cited By ~ 12

Author(s):

Ji Hyung Hong ◽

Hyon Ho Kim ◽

Eun Ji Han ◽

Jae Ho Byun ◽

Hong Seok Jang ◽

...

Keyword(s):

Esophageal Cancer ◽

Prognostic Factor ◽

Fdg Pet ◽

Locally Advanced ◽

Total Lesion Glycolysis ◽

Advanced Esophageal Cancer ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Locally Advanced Esophageal Cancer

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Prognostic value of 18F-FDG PET /CT metabolic parameters in patients with locally advanced pancreatic Cancer treated with stereotactic body radiation therapy

Cancer Imaging ◽

10.1186/s40644-020-00301-6 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Shengnan Ren ◽

Xiaofei Zhu ◽

Anyu Zhang ◽

Danni Li ◽

Changjing Zuo ◽

...

Keyword(s):

Pancreatic Cancer ◽

Radiation Therapy ◽

Fdg Pet ◽

Prognostic Value ◽

Stereotactic Body Radiation Therapy ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Preoperative PET/CT 18F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer

Contrast Media & Molecular Imaging ◽

10.1155/2018/5802109 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Ruohua Chen ◽

Yining Wang ◽

Xiang Zhou ◽

Gang Huang ◽

Jianjun Liu

Keyword(s):

Colorectal Cancer ◽

Lymph Nodes ◽

Fdg Pet ◽

Prognostic Value ◽

Treatment Modalities ◽

Significant Prognostic Factor ◽

Tumour Grade ◽

Characteristic Analysis ◽

Pet Ct ◽

Fdg Pet Ct

Purpose. We evaluated the prognostic value of preoperative 18F-FDG uptake by suspected lymph nodes (LNs) using 18F-FDG PET/CT in colorectal cancer patients. Methods. Patients with CRC underwent 18F-FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the 18F-FDG maximum standardized uptake value (SUVmax) in the suspected LNs (SUVLN) on 18F-FDG PET/CT. Results. Clinical data, treatment modalities, and results from 90 CR C patients were reviewed. The median follow-up was 19 months (range 3 to 72 months). Receiver operating characteristic analysis identified SUVLN 1.15 was the optimal cut-off value for predicting recurrence. SUVLN correlated with tumour size (P=0.045), lymph node metastasis (P=0.03), and recurrence (P<0.0001). Univariate analysis showed significant associations between recurrence and SUVLN (P=0.017), and tumour grade (P=0.013). Multivariate analysis identified SUVLN (P<0.0001), and tumour grade (P=0.005) as independent risk factors for recurrence. Patients with SUVLN ≤ 1.15 and SUVLN > 0.15 differed significantly in terms of recurrence (P<0.0001). Conclusion. Preoperative SUVLN measured by 18F-FDG PET/CT was significantly associated with recurrence and had significant prognostic value for recurrence-free survival in patients with colorectal cancer.

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Total lesion glycolysis (TLG) at baseline FDG-PET/CT compared with maximum standard uptake value (SUVmax) to predict survival in non-small cell lung cancer (NSCLC).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.7579 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 7579-7579

Author(s):

Ling Li ◽

Feng-Ming (Spring) Kong ◽

Nan Bi ◽

Jingbo Wang ◽

Pawinee Mahasittiwat ◽

...

Keyword(s):

Prognostic Factor ◽

Fdg Pet ◽

Tumor Volume ◽

Background Level ◽

Metabolic Tumor Volume ◽

Significant Prognostic Factor ◽

Pet Ct ◽

Fdg Pet Ct ◽

Nsclc Patients

7579 Background: SUVmaxat baseline FDG-PET has been reported as a significant prognostic factor while recent studies suggest that metabolic tumor volume (MTV) may be more important factor in patients with NSCLC. We hypothesized that TLG is a better prognostic factor than either SUVmax or MTV alone for overall survival (OS) and progression free survival (PFS) in NSCLC because it integrates both volumetric and biologic activity. Methods: The study population included a prospectively recruited cohort of stage I-III NSCLC patients treated with chemoradiation. FDG PET/CT scans were performed within 2 weeks from treatment start. The SUV in the tumor was normalized to that of the background level in the middle of ascending aorta to minimize the confounding effect from inter-scan variation in SUV measurement. MTV was delineated by auto-threshold at 1.5 times background level in the aorta followed by knowledge based manual editing. Mean and maximum SUV normalized to the background level were computed. TLG was calculated as the product of lesion SUVmean and MTV. Results: A total of 96 patients with minimum follow-up of 1 year were eligible. The median follow-up among survivors was 30 months. Univariate analysis demonstrated that MTV and TLG were significant factors for both OS and PFS (all P<0.05). There was a significant correlation between SUVmean and PFS (P=0.013), but there was no significant association between SUVmean and OS. SUVmax was not a significant factor for either OS or PFS (all P>0.05). Under multivariate Cox regression analysis, MTV (HR= 2.62, P= 0.003) and NSUVmean (HR=0.351, P=0.003) were significantly associated with PFS; but only TLG was significantly associated with OS (HR=2.14, P=0.006)adjusted by of TNM stage and other clinical factors. Conclusions: These results support our hypothesis that metabolic tumor volume and biologic average glucose metabolic activity of this volume are more important prognostic factors for overall prognosis than SUVmax in NSCLC patients treated with chemoradiation. Should this be validated by independent studies, future clinical trial should take this into consideration for individualized care.

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