Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy

Hánah N. Rier; Agnes Jager; Stefan Sleijfer; Joost van Rosmalen; Marc C.J.M. Kock; Mark David Levin

doi:10.1016/j.breast.2016.10.014

Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy

Hánah N. Rier^*, Agnes Jager, Stefan Sleijfer, Joost van Rosmalen, Marc C.J.M. Kock, Mark David Levin

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

120 Citations (Scopus)

119 Downloads (Pure)

Abstract

Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm²/m² and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm²/m²), sarcopenic obesity (LMM and BMI ≥30 kg/m²) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.

Original language	English
Pages (from-to)	9-15
Number of pages	7
Journal	Breast
Volume	31
DOIs	https://doi.org/10.1016/j.breast.2016.10.014
Publication status	Published - Feb 2017

Bibliographical note

Funding Information:
This study was funded by ORAS (Oncological Research Albert Schweitzer hospital) and the Leerhuis of the Albert Schweitzer hospital, Dordrecht, the Netherlands. The foundation and the Leerhuis had no involvement in the conduct of the study.

Publisher Copyright:
© 2016 Elsevier Ltd

Research programs

EMC MM-03-86-01

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.breast.2016.10.014

REPUB_94221.pdfFinal published version, 441 KB

http://hdl.handle.net/1765/94221

Cite this

@article{2d80895d2e5c4995906c20b3962c8c3a,

title = "Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy",

abstract = "Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm2/m2 and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm2/m2), sarcopenic obesity (LMM and BMI ≥30 kg/m2) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.",

author = "Rier, {H{\'a}nah N.} and Agnes Jager and Stefan Sleijfer and {van Rosmalen}, Joost and Kock, {Marc C.J.M.} and Levin, {Mark David}",

note = "Funding Information: This study was funded by ORAS (Oncological Research Albert Schweitzer hospital) and the Leerhuis of the Albert Schweitzer hospital, Dordrecht, the Netherlands. The foundation and the Leerhuis had no involvement in the conduct of the study. Publisher Copyright: {\textcopyright} 2016 Elsevier Ltd",

year = "2017",

month = feb,

doi = "10.1016/j.breast.2016.10.014",

language = "English",

volume = "31",

pages = "9--15",

journal = "Breast",

issn = "0960-9776",

publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy

AU - Rier, Hánah N.

AU - Jager, Agnes

AU - Sleijfer, Stefan

AU - van Rosmalen, Joost

AU - Kock, Marc C.J.M.

AU - Levin, Mark David

N1 - Funding Information: This study was funded by ORAS (Oncological Research Albert Schweitzer hospital) and the Leerhuis of the Albert Schweitzer hospital, Dordrecht, the Netherlands. The foundation and the Leerhuis had no involvement in the conduct of the study. Publisher Copyright: © 2016 Elsevier Ltd

PY - 2017/2

Y1 - 2017/2

N2 - Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm2/m2 and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm2/m2), sarcopenic obesity (LMM and BMI ≥30 kg/m2) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.

AB - Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm2/m2 and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm2/m2), sarcopenic obesity (LMM and BMI ≥30 kg/m2) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.

UR - http://www.scopus.com/inward/record.url?scp=84994248989&partnerID=8YFLogxK

U2 - 10.1016/j.breast.2016.10.014

DO - 10.1016/j.breast.2016.10.014

M3 - Article

C2 - 27810702

SN - 0960-9776

VL - 31

SP - 9

EP - 15

JO - Breast

JF - Breast

ER -

Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy

Abstract

Bibliographical note

Research programs

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this