Intermuscular fat density as a novel prognostic factor in breast cancer patients treated with adjuvant chemotherapy.
Breast cancer
Chemotherapy
Fat density
Survival
Visceral obesity
Journal
Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
25
04
2021
accepted:
27
06
2021
pubmed:
21
7
2021
medline:
14
10
2021
entrez:
20
7
2021
Statut:
ppublish
Résumé
Body composition, including sarcopenia and fat parameters, has received much attention as a prognostic factor in breast cancer. A total of 479 breast cancer patients who underwent surgery and received adjuvant chemotherapy were enrolled in this study. Body composition, including the index and density of skeletal muscle, visceral fat, subcutaneous fat, and intermuscular fat calculated by CT scan, was used as a prognostic factor. The endpoints were breast cancer-specific survival (BCSS) and overall survival (OS). The number of patients with stages I, II, and III was 146 (30.5%), 237 (49.5%), and 96 (20%), respectively. Sarcopenia and muscle density were not significant prognostic factors for BCSS and OS. A high visceral fat index (VFI) was an independent prognostic factor for BCSS (HR, 2.55; 95% CI 1.10-5.95, p = 0.03) and OS (HR 2.55, 95% CI 1.26-5.16, p = 0.01). In addition, high intermuscular fat density (IMFD) was also a significant prognostic factor for BCSS (HR, 2.95; 95% CI 1.34-6.46, p = 0.007) and OS (HR 2.28, 95% CI 1.22-4.26, p = 0.01) in multivariate analysis. VFI and IMFD were significant prognostic factors for BCSS and OS in breast cancer patients treated with adjuvant chemotherapy.
Sections du résumé
BACKGROUND
BACKGROUND
Body composition, including sarcopenia and fat parameters, has received much attention as a prognostic factor in breast cancer.
METHODS
METHODS
A total of 479 breast cancer patients who underwent surgery and received adjuvant chemotherapy were enrolled in this study. Body composition, including the index and density of skeletal muscle, visceral fat, subcutaneous fat, and intermuscular fat calculated by CT scan, was used as a prognostic factor. The endpoints were breast cancer-specific survival (BCSS) and overall survival (OS).
RESULTS
RESULTS
The number of patients with stages I, II, and III was 146 (30.5%), 237 (49.5%), and 96 (20%), respectively. Sarcopenia and muscle density were not significant prognostic factors for BCSS and OS. A high visceral fat index (VFI) was an independent prognostic factor for BCSS (HR, 2.55; 95% CI 1.10-5.95, p = 0.03) and OS (HR 2.55, 95% CI 1.26-5.16, p = 0.01). In addition, high intermuscular fat density (IMFD) was also a significant prognostic factor for BCSS (HR, 2.95; 95% CI 1.34-6.46, p = 0.007) and OS (HR 2.28, 95% CI 1.22-4.26, p = 0.01) in multivariate analysis.
CONCLUSION
CONCLUSIONS
VFI and IMFD were significant prognostic factors for BCSS and OS in breast cancer patients treated with adjuvant chemotherapy.
Identifiants
pubmed: 34283341
doi: 10.1007/s10549-021-06322-4
pii: 10.1007/s10549-021-06322-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
759-768Subventions
Organisme : Korea Health Industry Development Institute
ID : HI18C1216
Pays : Republic of Korea
Organisme : National Research Foundation of Korea
ID : 2020R1C1C1013598
Organisme : Catholic University of Korea
ID : the program year of 2020
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Rossi F, Valdora F, Bignotti B, Torri L, Succio G, Tagliafico AS (2019) Evaluation of body computed tomography-determined sarcopenia in breast cancer patients and clinical outcomes: a systematic review. Cancer Treat Res Commun 21:100154. https://doi.org/10.1016/j.ctarc.2019.100154
doi: 10.1016/j.ctarc.2019.100154
pubmed: 31220793
Saltzman E, Mogensen KM (2013) Physical and clinical assessment of nutrition status. Nutrition in the prevention and treatment of disease, 3rd edn. Elsevier, Amsterdam
Chan DS, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, Navarro Rosenblatt D, Thune I, Vieira R, Norat T (2014) Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 25:1901–1914. https://doi.org/10.1093/annonc/mdu042
doi: 10.1093/annonc/mdu042
pubmed: 24769692
pmcid: 4176449
Jeon YW, Kang SH, Park MH, Lim W, Cho SH, Suh YJ (2015) Relationship between body mass index and the expression of hormone receptors or human epidermal growth factor receptor 2 with respect to breast cancer survival. BMC Cancer 15:865. https://doi.org/10.1186/s12885-015-1879-4
doi: 10.1186/s12885-015-1879-4
pubmed: 26546331
pmcid: 4636815
Greenlee H, Unger JM, LeBlanc M, Ramsey S, Hershman DL (2017) Association between body mass index and cancer survival in a pooled analysis of 22 clinical trials. Cancer Epidemiol Biomark Prev 26:21–29. https://doi.org/10.1158/1055-9965.EPI-15-1336
doi: 10.1158/1055-9965.EPI-15-1336
Stefan N, Haring HU, Hu FB, Schulze MB (2013) Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. Lancet Diabetes Endocrinol 1:152–162. https://doi.org/10.1016/S2213-8587(13)70062-7
doi: 10.1016/S2213-8587(13)70062-7
pubmed: 24622321
Caan BJ, Cespedes Feliciano EM, Prado CM, Alexeeff S, Kroenke CH, Bradshaw P, Quesenberry CP, Weltzien EK, Castillo AL, Olobatuyi TA, Chen WY (2018) Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol 4:798–804. https://doi.org/10.1001/jamaoncol.2018.0137
doi: 10.1001/jamaoncol.2018.0137
pubmed: 29621380
pmcid: 6584322
Song EJ, Lee CW, Jung SY, Kim BN, Lee KS, Lee S, Kang HS, Park IH, Lee MH, Kim YJ, Ko K, Kim S, Nam BH, Lee ES (2018) Prognostic impact of skeletal muscle volume derived from cross-sectional computed tomography images in breast cancer. Breast Cancer Res Treat 172:425–436. https://doi.org/10.1007/s10549-018-4915-7
doi: 10.1007/s10549-018-4915-7
pubmed: 30132218
Huh J, Park B, Lee H, An YS, Jung Y, Kim JY, Kang DK, Kim KW, Kim TH (2020) Prognostic value of skeletal muscle depletion measured on computed tomography for overall survival in patients with non-metastatic breast cancer. J Breast Cancer 23:80–92. https://doi.org/10.4048/jbc.2020.23.e8
doi: 10.4048/jbc.2020.23.e8
pubmed: 32140272
pmcid: 7043943
Del Fabbro E, Parsons H, Warneke CL, Pulivarthi K, Litton JK, Dev R, Palla SL, Brewster A, Bruera E (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
doi: 10.1634/theoncologist.2012-0169
pubmed: 22903527
pmcid: 3481889
Neefjes ECW, van den Hurk RM, Blauwhoff-Buskermolen S, van der Vorst M, Becker-Commissaris A, de van der Schueren MAE, Buffart LM, Verheul HMW (2017) Muscle mass as a target to reduce fatigue in patients with advanced cancer. J Cachexia Sarcopenia Muscle 8:623–629. https://doi.org/10.1002/jcsm.12199
doi: 10.1002/jcsm.12199
pubmed: 28639432
pmcid: 5566642
Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, McCargar LJ, Murphy R, Ghosh S, Sawyer MB, Baracos VE (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31:1539–1547. https://doi.org/10.1200/JCO.2012.45.2722
doi: 10.1200/JCO.2012.45.2722
pubmed: 23530101
Cote JA, Nazare JA, Nadeau M, Leboeuf M, Blackburn L, Despres JP, Tchernof A (2016) Computed tomography-measured adipose tissue attenuation and area both predict adipocyte size and cardiometabolic risk in women. Adipocyte 5:35–42. https://doi.org/10.1080/21623945.2015.1106057
doi: 10.1080/21623945.2015.1106057
pubmed: 27144095
Kim EH, Kim KW, Shin Y, Lee J, Ko Y, Kim YJ, Lee MJ, Bae SJ, Park SW, Choe J, Kim HK (2020) Reference data and T-scores of lumbar skeletal muscle area and its skeletal muscle indices measured by CT scan in a healthy Korean population. J Gerontol A Biol Sci Med Sci. https://doi.org/10.1093/gerona/glaa065
doi: 10.1093/gerona/glaa065
pubmed: 32396611
pmcid: 8202142
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) AJCC Cancer Staging Manual, 7th edn. Springer, New York
van den Berg M, Kok DE, Posthuma L, Kamps L, Kelfkens CS, Buist N, Geenen M, Haringhuizen A, Heijns JB, van Lieshout R, Los M, Sommeijer DW, Timmer-Bonte JNH, de Kruif A, van Laarhoven HWM, Kampman E, Winkels RM (2019) Body composition is associated with risk of toxicity-induced modifications of treatment in women with stage I-IIIB breast cancer receiving chemotherapy. Breast Cancer Res Treat 173:475–481. https://doi.org/10.1007/s10549-018-5014-5
doi: 10.1007/s10549-018-5014-5
pubmed: 30353244
Reding KW, Brubaker P, D’Agostino R Jr, Kitzman DW, Nicklas B, Langford D, Grodesky M, Hundley WG (2019) Increased skeletal intermuscular fat is associated with reduced exercise capacity in cancer survivors: a cross-sectional study. Cardiooncology 5:3. https://doi.org/10.1186/s40959-019-0038-5
doi: 10.1186/s40959-019-0038-5
pubmed: 32154010
pmcid: 7048042
Iwase T, Sangai T, Nagashima T, Sakakibara M, Sakakibara J, Hayama S, Ishigami E, Masuda T, Miyazaki M (2016) Impact of body fat distribution on neoadjuvant chemotherapy outcomes in advanced breast cancer patients. Cancer Med 5:41–48. https://doi.org/10.1002/cam4.571
doi: 10.1002/cam4.571
pubmed: 26626021
Iwase T, Sangai T, Fujimoto H, Sawabe Y, Matsushita K, Nagashima K, Sato Y, Nakagawa A, Masuda T, Nagashima T, Ohtsuka M (2020) Quality and quantity of visceral fat tissue are associated with insulin resistance and survival outcomes after chemotherapy in patients with breast cancer. Breast Cancer Res Treat 179:435–443. https://doi.org/10.1007/s10549-019-05467-7
doi: 10.1007/s10549-019-05467-7
pubmed: 31620935
Ebadi M, Martin L, Ghosh S, Field CJ, Lehner R, Baracos VE, Mazurak VC (2017) Subcutaneous adiposity is an independent predictor of mortality in cancer patients. Br J Cancer 117:148–155. https://doi.org/10.1038/bjc.2017.149
doi: 10.1038/bjc.2017.149
pubmed: 28588319
pmcid: 5520211
Antoun S, Bayar A, Ileana E, Laplanche A, Fizazi K, di Palma M, Escudier B, Albiges L, Massard C, Loriot Y (2015) High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting. Eur J Cancer 51:2570–2577. https://doi.org/10.1016/j.ejca.2015.07.042
doi: 10.1016/j.ejca.2015.07.042
pubmed: 26278649
Cespedes Feliciano EM, Chen WY, Lee V, Albers KB, Prado CM, Alexeeff S, Xiao J, Shachar SS, Caan BJ (2019) Body composition, adherence to anthracycline and taxane-based chemotherapy, and survival after nonmetastatic breast cancer. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2019.4668
doi: 10.1001/jamaoncol.2019.4668
pubmed: 31095251
pmcid: 6902178
Park HJ, Shin Y, Park J, Kim H, Lee IS, Seo DW, Huh J, Lee TY, Park T, Lee J, Kim KW (2020) Development and validation of a deep learning system for segmentation of abdominal muscle and fat on computed tomography. Korean J Radiol 21:88–100. https://doi.org/10.3348/kjr.2019.0470
doi: 10.3348/kjr.2019.0470
pubmed: 31920032
Kim DW, Kim KW, Ko Y, Park T, Khang S, Jeong H, Koo K, Lee J, Kim HK, Ha J, Sung YS, Shin Y (2020) Assessment of myosteatosis on computed tomography by automatic generation of a muscle quality map using a web-based toolkit: feasibility study. JMIR Med Inform 8:e23049. https://doi.org/10.2196/23049
doi: 10.2196/23049
pubmed: 33074159
pmcid: 7605976
Lee K, Shin Y, Huh J, Sung YS, Lee IS, Yoon KH, Kim KW (2019) Recent issues on body composition imaging for sarcopenia evaluation. Korean J Radiol 20:205–217. https://doi.org/10.3348/kjr.2018.0479
doi: 10.3348/kjr.2018.0479
pubmed: 30672160
Mukaka MM (2012) Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J 24:69–71
pubmed: 23638278
pmcid: 3576830
Cecile C, John OQ (1999) An application of changepoint methods in studying the effect of age on survival in breast cancer. Comput Stat Data Anal 30:253–270
doi: 10.1016/S0167-9473(98)00096-6
Zhang XM, Dou QL, Zeng Y, Yang Y, Cheng ASK, Zhang WW (2020) Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review. BMC Cancer 20:172. https://doi.org/10.1186/s12885-020-6645-6
doi: 10.1186/s12885-020-6645-6
pubmed: 32131764
pmcid: 7057618
Cespedes Feliciano EM, Chen WY, Lee V, Albers KB, Prado CM, Alexeeff S, Xiao J, Shachar SS, Caan BJ (2020) Body composition, adherence to anthracycline and taxane-based chemotherapy, and survival after nonmetastatic breast cancer. JAMA Oncol 6:264–270. https://doi.org/10.1001/jamaoncol.2019.4668
doi: 10.1001/jamaoncol.2019.4668
pubmed: 31804676
Zimta AA, Tigu AB, Muntean M, Cenariu D, Slaby O, Berindan-Neagoe I (2019) Molecular links between central obesity and breast cancer. Int J Mol Sci. https://doi.org/10.3390/ijms20215364
doi: 10.3390/ijms20215364
pubmed: 31661891
pmcid: 6862548
Catalano S, Marsico S, Giordano C, Mauro L, Rizza P, Panno ML, Ando S (2003) Leptin enhances, via AP-1, expression of aromatase in the MCF-7 cell line. J Biol Chem 278:28668–28676. https://doi.org/10.1074/jbc.M301695200
doi: 10.1074/jbc.M301695200
pubmed: 12734209
Addison O, Marcus RL, Lastayo PC, Ryan AS (2014) Intermuscular fat: a review of the consequences and causes. Int J Endocrinol 2014:309570. https://doi.org/10.1155/2014/309570
doi: 10.1155/2014/309570
pubmed: 24527032
pmcid: 3910392
Deluche E, Leobon S, Desport JC, Venat-Bouvet L, Usseglio J, Tubiana-Mathieu N (2018) Impact of body composition on outcome in patients with early breast cancer. Support Care Cancer 26:861–868. https://doi.org/10.1007/s00520-017-3902-6
doi: 10.1007/s00520-017-3902-6
pubmed: 28948392
Rosenquist KJ, Massaro JM, Pedley A, Long MT, Kreger BE, Vasan RS, Murabito JM, Hoffmann U, Fox CS (2015) Fat quality and incident cardiovascular disease, all-cause mortality, and cancer mortality. J Clin Endocrinol Metab 100:227–234. https://doi.org/10.1210/jc.2013-4296
doi: 10.1210/jc.2013-4296
pubmed: 25226289
Raggi P, Gadiyaram V, Zhang C, Chen Z, Lopaschuk G, Stillman AE (2019) Statins reduce epicardial adipose tissue attenuation independent of lipid lowering: a potential pleiotropic effect. J Am Heart Assoc 8:e013104. https://doi.org/10.1161/JAHA.119.013104
doi: 10.1161/JAHA.119.013104
pubmed: 31190609
pmcid: 6645620
Lee JW, Kim SY, Lee HJ, Han SW, Lee JE, Lee SM (2019) Prognostic significance of CT-attenuation of tumor-adjacent breast adipose tissue in breast cancer patients with surgical resection. Cancers (Basel). https://doi.org/10.3390/cancers11081135
doi: 10.3390/cancers11081135
pubmed: 31370314
pmcid: 7017279