Sarcopenia Diagnosed Using Masseter Muscle Diameter as a Survival Correlate in Elderly Patients with Glioblastoma.
Sarcopenia Diagnosed Using Masseter Muscle Diameter as a Survival Correlate in Elderly Patients with Glioblastoma.
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肌肉减少症使用咬肌直径诊断为胶质母细胞瘤患者的生存率相关。
DOI：
10.1016/j.wneu.2022.02.038
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发表时间：
2022-05
影响因子：
2
通讯作者：
Hervey-Jumper, Shawn L.
中科院分区：
文献类型：
--
作者：
Morshed, Ramin A.;Young, Jacob S.;Casey, Megan;Wang, Elaina J.;Aghi, Manish K.;Berger, Mitchel S.;Hervey-Jumper, Shawn L.
老年胶质母细胞瘤（GBM）患者的预后比年轻患者差。本研究旨在确定患者、治疗和影像学特征，包括与老年GBM患者生存率和术后90天死亡率较差相关的肌肉减少症指标。对初次诊断时接受过世界卫生组织IV级GBM活检或切除术的手术时年龄≥79岁的患者进行了一项单中心回顾性研究。收集骨骼肌减少症的影像学特征，包括咬肌和颞肌的直径。进行多变量分析，以确定与生存率和30天并发症相关的因素。该队列包括110例患者，手术时平均年龄为82.8岁，术前Karnofsky体能量表评分中位数为80。大多数患者接受了手术切除（66.4%），而少数患者接受了活检（33.6%）。72.5%的患者接受了辅助化疗和/或放疗。在多变量分析中，年龄（风险比[HR]，7.97; 95%置信区间[CI]，1.63-36.3），辅助治疗（RT或TMZ与无：HR，0.12; 95% CI，0.05-0.3; RT + TMZ与无：HR，0.05; 95% CI，0.02-0.14），手术切除（HR，0.46; 95%CI，0.24-0.9）、多灶性（HR，2.7; 95%CI，1.14-6.4）和咬肌直径（HR，0.12; 95%CI，0.02-0.78）与生存率相关。咬肌直径是与手术切除后90天死亡率相关的唯一因素（P = 0.044）。79岁以上的GBM患者在切除后接受辅助化疗和RT后的结局可以接受。除了预测生存的治疗因素外，术前成像上咬肌直径减小（肌肉减少症的标志物）与总生存期缩短相关。手术切除后90天死亡率。
Elderly patients with glioblastoma (GBM) have a worse prognosis than do younger patients. The present study aimed to identify the patient, treatment, and imaging features, including measures of sarcopenia, associated with worse survival and 90-day postoperative mortality for elderly patients with GBM. A single-center retrospective study was conducted of patients aged ≥79 years at surgery who had undergone biopsy or resection of a World Health Organization grade IV GBM at the initial diagnosis. Imaging features of sarcopenia were collected, including the masseter and temporalis muscle diameters. Multivariate analyses were performed to identify factors associated with survival and 30-day complications. The cohort included 110 patients with a mean age of 82.8 years at surgery and a median preoperative Karnofsky performance scale score of 80. The majority of patients underwent a surgical resection (66.4%) while a minority underwent biopsy (33.6%). Adjuvant chemo- and/or radiation therapy were used in 72.5% of the cohort. On multivariate analysis, age (hazard ratio [HR], 7.97; 95% confidence interval [CI], 1.63–36.3), adjuvant therapy (RT or TMZ vs. none: HR, 0.12; 95% CI, 0.05–0.3; RT plus TMZ vs. none: HR, 0.05; 95% CI, 0.02–0.14), surgical resection (HR, 0.46; 95% CI, 0.24–0.9), multifocality (HR, 2.7; 95% CI, 1.14–6.4), and masseter diameter (HR, 0.12; 95% CI, 0.02–0.78) were associated with survival. Masseter diameter was the only factor associated with 90-day mortality after surgical resection (P = 0.044). GBM patients over the age of 79 have acceptable outcomes after resection, followed by adjuvant chemotherapy and RT. In addition to the treatment factors that predicted for survival, a decreased masseter diameter on preoperative imaging, a marker of sarcopenia, was associated with shorter overall survival and 90-day mortality after surgical resection.
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影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
1.9
作者：
Hager, Jasmin;Herrmann, Eva;Quick-Weller, Johanna
通讯作者：
Quick-Weller, Johanna
影响因子：
4.1
作者：
Oszvald, Agi;Gueresir, Erdem;Franz, Kea
通讯作者：
Franz, Kea
影响因子：
4.7
作者：
Gronberg, Bjorn H.;Sjoblom, Bjorg;Jordhoy, Marit
通讯作者：
Jordhoy, Marit
颅磁共振图像颞肌厚度测量对原发性胶质母细胞瘤患者预后的预测价值
影响因子：
3.4
作者：
Liu F;Xing D;Zha Y;Wang L;Dong W;Li L;Gong W;Hu L
通讯作者：
Hu L