Association of adipose tissue and skeletal muscle metrics with overall survival and postoperative complications in soft tissue sarcoma patients: an opportunistic study using computed tomography
Association of adipose tissue and skeletal muscle metrics with overall survival and postoperative complications in soft tissue sarcoma patients: an opportunistic study using computed tomography
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DOI：
10.21037/qims.2020.02.09
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发表时间：
2020-08-01
影响因子：
2.8
通讯作者：
Lenchik, Leon
中科院分区：
文献类型：
--
作者：
Boutin, Robert D.;Katz, Jeremy R.;Lenchik, Leon
背景：为了确定计算机断层扫描 (CT) 上的脂肪组织和骨骼肌测量值与软组织肉瘤 (STS) 患者的总生存率和主要术后并发症之间的关系。方法：回顾性研究包括 137 名进行腹部 CT 检查的 STS 患者（75 名男性，62 名女性；平均年龄，53 岁，SD 17.7；平均 BMI，28.5，SD 6.6）。在单张 CT 图像上，在 L4 椎弓根水平上，使用临床 PACS 和专用分割软件获得内脏脂肪组织 (VAT)、皮下脂肪组织 (SAT) 以及骨骼肌面积和衰减的测量结果。记录临床信息，包括 STS 特征（大小、深度、分级、分期和部位）、总生存率和术后并发症。使用 Cox 比例风险模型分析 CT 指标与生存率之间的关系，并使用 Logistic 回归模型分析 CT 指标与术后并发症之间的关系。结果：死亡 33 例，主要术后并发症 41 例。根据临床 PACS 测量，腰肌面积 (P=0.003)、腰肌指数 (P=0.006)、腰肌衰减 (P=0.011) 和总肌肉衰减 (P=0.023) 与总生存期相关。使用专门的软件，腰肌衰减也与总生存期相关（P=0.018）。脂肪组织指标与生存或术后并发症无关。结论：在 STS 患者中，CT 得出的肌肉大小和衰减与总体生存相关。这些预后生物标志物可以使用专门的分割软件或常规临床 PACS 获得。
Background: To determine the relationship between adipose tissue and skeletal muscle measurements on computed tomography (CT) and overall survival and major postoperative complications in patients with soft-tissue sarcoma (STS).Methods: The retrospective study included 137 STS patients (75 men, 62 women; mean age, 53 years, SD 17.7; mean BMI, 28.5, SD 6.6) who had abdominal CT exams. On a single CT image, at the L4 pedicle level, measurements of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area and attenuation were obtained using clinical PACS and specialized segmentation software. Clinical information was recorded, including STS characteristics (size, depth, grade, stage, and site), overall survival, and postoperative complications. The relationships between CT metrics and survival were analyzed using Cox proportional hazard models and those between CT metrics and postoperative complications using logistic regression models.Results: There were 33 deaths and 41 major postoperative complications. Measured on clinical PACS, the psoas area (P=0.003), psoas index (P=0.006), psoas attenuation (P=0.011), and total muscle attenuation (P=0.023) were associated with overall survival. Using specialized software, psoas attenuation was also associated with overall survival (P=0.018). Adipose tissue metrics were not associated with survival or postoperative complications.Conclusions: In STS patients, CT-derived muscle size and attenuation are associated with overall survival. These prognostic biomarkers can be obtained using specialized segmentation software or routine clinical PACS.