High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting
High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting
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DOI：
10.1016/j.ejca.2015.07.042
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发表时间：
2015-11-01
影响因子：
8.4
通讯作者：
Loriot, Yohann
中科院分区：
文献类型：
--
作者：
Antoun, Sami;Bayar, Amine;Loriot, Yohann
背景资料：癌症研究表明，体重指数（BMI）、骨骼肌质量（SMM）和脂肪组织指数与总生存期（OS）和无进展生存期（PFS）相关。新治疗（醋酸阿比特龙、恩杂鲁胺卡巴他赛、镭-223、sipuleucel-T）改善了转移性去势抵抗性前列腺癌（mCRPC）的患者结局。我们的目的是分析身体组成参数是否发挥下一代雄激素受体（AR）轴抑制剂（阿比特龙和恩杂鲁胺）治疗的mCRPC患者的预后作用。方法：所有mCRPC患者从我们的机构入组两个前瞻性试验，评估醋酸阿比特龙的疗效和恩杂鲁胺的疗效，被选中。结果：在120例有资料的患者中，中位OS和PFS分别为16个月（95%可信区间[CI] = 12-19）和4个月（95%可信区间[CI] = 3-6）。OS与SAT指数相关：SAT指数<中位数的患者中位生存期为15个月（95% [CI] 9-18），SAT指数高于中位数的患者中位生存期为18个月（95% [CI] 13-30）（P = 0.008）。在多变量分析中，只有内脏转移的发生（P = 0.004），疼痛（P = 0.015）和SAT指数（P = 0.036）是OS的统计学显著预测因素。从基线到3个月，SMM指数损失为2.49 +/- 0.44 cm（2）/m（2）（P < 0.001）相当于近3.4 kg的肌肉损失。在接受下一代AR轴抑制剂治疗的mCRPC患者中，高SAT量与总生存期独立相关。(C)2015爱思唯尔有限公司版权所有。
Background: Cancer studies have shown that body mass index (BMI), skeletal muscle mass (SMM) and adipose tissue indexes are linked to overall survival (OS) and progression-free survival (PFS). New treatments (abiraterone acetate, enzalutamide cabazitaxel, radium-223, sipuleucel-T) have improved patient outcomes in metastatic castration-resistant prostate cancer (mCRPC). Our objective was to analyse whether body composition parameters exert a prognostic role in mCRPC patients treated with next generation of androgen receptor (AR) axis inhibitors (abiraterone and enzalutamide).Methods: All mCRPC patients from our institution who were enrolled in two prospective trials, assessing the efficacy of abiraterone acetate and the efficacy of enzalutamide, were selected. SMM, visceral and subcutaneous adipose tissue (SAT) indexes were assessed with computed tomography imaging by measuring cross-sectional areas of the tissues.Results: In the 120 patients with available data, median OS and PFS were respectively: 16 months (95% confidence interval [CI] = 12-19) and 4 months (95% [CI] = 3-6). OS was associated with the SAT index: median survival was 15 months (95% [CI] 9-18) for patients with a SAT index < median value and 18 months (95% [CI] 13-30) for patients with a SAT index above (P = 0.008). In multivariate analyses, only the occurrence of visceral metastasis (P = 0.004), pain (P = 0.015) and SAT index (P = 0.036) were statistically significant predictors of OS. From baseline to 3 months, the SMM index loss was 2.49 +/- 0.44 cm(2)/m(2) (P < 0.001) corresponding to nearly 3.4 kg of muscle loss.Conclusions: High volume of SAT is independently associated with overall survival in mCRPC patients treated with next generation AR axis inhibitors. (C) 2015 Elsevier Ltd. All rights reserved.