We investigated the impact of body composition on outcomes of patients with early breast cancer. Skeletal muscle mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and muscle fat infiltration or inter-muscular adipose tissue areas (IMAT), obtained by computed tomography (CT), were assessed.
A total of 119 female patients who had breast cancer were included in this retrospective study. The total skeletal muscle and fat tissue areas were evaluated in two adjacent axial slices obtained at the third lumbar vertebra by CT used for disease staging. The women were assigned to either a sarcopenia or non-sarcopenia group based on their skeletal muscle index (cut-off 41.0 cm2/m2). They also were classified into high and low VAT/SAT ratio groups and assigned to either the high or low IMAT index group. The association of the body composition parameters and prognosis was statistically analyzed.
Among the 119 evaluable patients, 58 were sarcopenic (48.8%), 55 (46.2%) had a high VAT/SAT ratio, and 62 (52.1%) had a high IMAT index. Median follow-up was 52.4 months. Multivariate analysis revealed sarcopenia and IMAT index as independent prognostic factors for disease-free survival (p = 0.02 and p = 0.04, respectively) and overall survival (p = 0.05 and p = 0.02, respectively). BMI was not significantly associated with disease-free survival, but a trend was observed (p = 0.09).
Sarcopenia and IMAT index are independent prognostic factors in early breast cancer; therefore, assessing body composition could be a simple and useful approach to integrate into patient management.
Stewart B, Wild CP et al (2014) World cancer report 2014
Senesse P, Bachmann P, Bensadoun RJ et al (2014) Clinical nutrition guidelines of the French Speaking Society of Clinical Nutrition and Metabolism (SFNEP): summary of recommendations for adults undergoing non-surgical anticancer treatment. Dig Liver Dis. https://doi.org/10.1016/j.dld.2014.01.160
Herlevic VC, Mowad R, Miller JK et al (2015) Breast cancer outcomes in a population with high prevalence of obesity. J Surg Res 198:371–376. https://doi.org/10.1016/j.jss.2015.03.088 CrossRefPubMed
von Drygalski A, Tran TB, Messer K et al (2011) Obesity is an independent predictor of poor survival in metastatic breast cancer: retrospective analysis of a patient cohort whose treatment included high-dose chemotherapy and autologous stem cell support. Int J Breast Cancer 2011:1–8. https://doi.org/10.4061/2011/523276 CrossRef
Cecchini RS, Swain SM, Costantino JP et al (2016) Body mass index at diagnosis and breast cancer survival prognosis in clinical trial populations from NRG Oncology/NSABP B-30, B-31, B-34, and B-38. Cancer Epidemiol Prev Biomark 25:51–59. https://doi.org/10.1158/1055-9965.EPI-15-0334-T CrossRef
Prado CMM, Lieffers JR, McCargar LJ et al (2008) Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol 9:629–635. https://doi.org/10.1016/S1470-2045(08)70153-0 CrossRefPubMed
Mitsiopoulos N, Baumgartner RN, Heymsfield SB et al (1998) Cadaver validation of skeletal muscle measurement by magnetic resonance imaging and computerized tomography. J Appl Physiol Bethesda Md 85:115–122
Rutten IJ, Dijk DP, Kruitwagen RF et al (2016) Loss of skeletal muscle during neoadjuvant chemotherapy is related to decreased survival in ovarian cancer patients. J Cachex Sarcopenia Muscle 7:458–466. https://doi.org/10.1002/jcsm.12107
Anandavadivelan P, Brismar TB, Nilsson M et al (2016) Sarcopenic obesity: a probable risk factor for dose limiting toxicity during neo-adjuvant chemotherapy in oesophageal cancer patients. Clin Nutr 35:724–730. https://doi.org/10.1016/j.clnu.2015.05.011 CrossRefPubMed
Antoun S, Borget I, Lanoy E (2013) Impact of sarcopenia on the prognosis and treatment toxicities in patients diagnosed with cancer. Curr Opin Support Palliat Care 7:383–389. https://doi.org/10.1097/SPC.0000000000000011 CrossRefPubMed
Shachar SS, Williams GR, Muss HB, Nishijima TF (2016) Prognostic value of sarcopenia in adults with solid tumours: a meta-analysis and systematic review. Eur J Cancer Oxf Engl 57:58–67. https://doi.org/10.1016/j.ejca.2015.12.030 CrossRef
Fabbro ED, Parsons H, Warneke CL et al (2012) The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer. Oncologist 17:1240–1245. https://doi.org/10.1634/theoncologist.2012-0169 CrossRefPubMedPubMedCentral
Antoun S, Bayar A, Ileana E et al (2015) High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting. Eur J Cancer Oxf Engl 51:2570–2577. https://doi.org/10.1016/j.ejca.2015.07.042 CrossRef
Cutuli B, Giard-Lefevre S, Antoine M et al (2012) Cancer du sein infiltrant non métastatique - questions d’actualités (synthèse) 82. www.e-cancer.fr/content/download/95914/1021156/file/RECOSEININFILT12.PDF
Shen W, Punyanitya M, Wang Z et al (2004) Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol Bethesda Md 97:2333–2338. https://doi.org/10.1152/japplphysiol.00744.2004
Shachar SS, Deal AM, Weinberg M et al (2016) Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane based chemotherapy. Clin Cancer Res Clincanres. https://doi.org/10.1158/1078-0432.CCR-16-0940
Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis report of the European working group on sarcopenia in older people. Age Ageing 39:412–423. https://doi.org/10.1093/ageing/afq034
Fielding R, Kirn D, Koochek A et al (2016) PT02.5: impact of a structured physical activity program and nutritional supplementation on regional body composition: results from the Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2). Clin Nutr 35:S25. https://doi.org/10.1016/S0261-5614(16)30294-1 CrossRef
van Dijk DPJ, Bakens MJAM, Coolsen MME et al (2016) Low skeletal muscle radiation attenuation and visceral adiposity are associated with overall survival and surgical site infections in patients with pancreatic cancer. J Cachexia Sarcopenia Muscle. https://doi.org/10.1002/jcsm.12155
Kim TY, Kim MY, Sohn JH et al (2014) Sarcopenia as a useful predictor for long-term mortality in cirrhotic patients with ascites. J Korean Med Sci 29:1253–1259. https://doi.org/10.3346/jkms.2014.29.9.1253 CrossRefPubMedPubMedCentral
Matsuzawa Y (2002) New criteria for “obesity disease” in Japan: the Examination Committee of Criteria for “Obesity Disease” in Japan, Japan Society for the Study of Obesity. Circ J Off J Jpn Circ Soc 66:987–992
Xiao J, Mazurak VC, Olobatuyi TA et al (2016) Visceral adiposity and cancer survival: a review of imaging studies. Eur J Cancer Care (Engl). https://doi.org/10.1111/ecc.12611
- Impact of body composition on outcome in patients with early breast cancer
Jean Claude Desport
- Springer Berlin Heidelberg
Neu im Fachgebiet Onkologie
Mail Icon II