Prognostic impact of sarcopenia in patients with metastatic hormone-sensitive prostate cancer
Prognostic impact of sarcopenia in patients with metastatic hormone-sensitive prostate cancer
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DOI：
10.1093/jjco/hyaa045
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发表时间：
2020-08-01
影响因子：
2.4
通讯作者：
Tanabe, Kazunari
中科院分区：
文献类型：
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作者：
Ikeda, Takashi;Ishihara, Hiroki;Tanabe, Kazunari
背景：癌症恶病质与不良预后相关。本研究旨在探讨肌肉减少症与转移性激素敏感性前列腺癌患者生存的关系。方法：我们回顾性评估了2008年1月至2015年12月期间我科及其附属机构诊断为转移性激素敏感性前列腺癌的197例患者。根据性别特异性共识定义诊断肌肉减少症。采用Kaplan-Meier方法计算转移性前列腺癌敏感性诊断的去势抵抗性前列腺癌无瘤生存期、癌症特异性生存期和总生存期，并采用对数秩检验进行比较。结果：163例（82.7%）患者存在肌肉减少症，其中163例（82.7%）患者存在肌肉减少症。肌肉减少症患者的癌症特异性生存期和总生存期明显短于非肌肉减少症患者（中位癌症特异性生存期：77.0个月vs.未达到，P = 0.0099;总生存期：72.0个月与未达到，P = 0.0465），而去势抵抗性前列腺癌无瘤生存率在两组之间没有显著差异（P = 0.6063）。多变量分析显示，肌肉减少症是癌症特异性生存的独立因素（风险比：2.18，P = 0.0451），以及Gleason评分（风险比：1.87，P = 0.0272）和LATITUDE风险分类（风险比：2.73，P = 0.0008）。此外，年龄≥ 73.0岁的患者中，肌肉减少症的预后相关性显著（癌症特异性生存期：分别为76.0和75.0个月，P = 0.7879;总生存期：分别为67.0和52.0个月，P = 0.7263）。肌肉减少症是转移性前列腺癌患者癌症特异性生存的独立危险因素，尤其是在年轻患者中。
Background: Cancer cachexia is associated with a poor prognosis. This study aimed to investigate the association between sarcopenia and survival in patients with metastatic hormone-sensitive prostate cancer.Methods: We retrospectively evaluated 197 patients diagnosed with metastatic hormone-sensitive prostate cancer in our department and its affiliated institution between January 2008 and December 2015. Sarcopenia was diagnosed according to the sex-specific consensus definition. Castration-resistance prostate cancer-free survival, cancer-specific survival and overall survival from the metastatic hormone-sensitive prostate cancer diagnoses were calculated using the Kaplan-Meier method and compared using the log-rank test. Risk factors affecting the survival outcomes were analyzed using the Cox proportional regression analysis.Results: In total, 163 patients (82.7%) had sarcopenia. Cancer-specific survival and overall survival were significantly shorter in sarcopenic patients than in non-sarcopenic patients (median cancer-specific survival: 77.0 months vs. not reached, P = 0.0099; overall survival: 72.0 months vs. not reached, P = 0.0465), whereas castration-resistance prostate cancer-free survival did not significantly differ between the groups (P = 0.6063). Multivariate analyses showed that sarcopenia was an independent factor for cancer-specific survival (hazard ratio: 2.18, P = 0.0451), together with the Gleason score (hazard ratio: 1.87, P = 0.0272) and LATITUDE risk classification (hazard ratio: 2.73, P = 0.0008). Moreover, the prognostic association of sarcopenia was remarkable in patients aged = 73.0 years (cancer-specific survival: 76.0 and 75.0 months, respectively, P = 0.7879; overall survival: 67.0 and 52.0 months, respectively, P = 0.7263).Conclusion: Sarcopenia was an independent risk factor of cancer-specific survival in patients with metastatic hormone-sensitive prostate cancer, especially in younger patients.