Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases
Objectives To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with 90 Yttrium microspheres. Methods Patients with mCRC who underwent RE in our center were inc...
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| Veröffentlicht in: | European radiology 2019-09, Vol.29 (9), p.4709-4717 |
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| creator | Faron, Anton Pieper, Claus C. Schmeel, Frederic C. Sprinkart, Alois M. Kuetting, Daniel L. R. Fimmers, Rolf Trebicka, Jonel Schild, Hans H. Meyer, Carsten Thomas, Daniel Luetkens, Julian A. |
| description | Objectives
To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with
90
Yttrium microspheres.
Methods
Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm
2
in men and 2825 mm
2
in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed.
Results
Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days,
p
= 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652;
p
|
| doi_str_mv | 10.1007/s00330-018-5976-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179435449</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2179435449</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-f50d67e35d44fbb58228b2167f6fdf73fd5d8ce4d28b5eb683d4ddd6c67e4daa3</originalsourceid><addsrcrecordid>eNp1kcGKFDEQhoMo7uzqA3iRgBcvrUkn3ek-yrKrCwte9BzSSWXIkk7GpHtg53l8UKuZVUEQAoGq7_9TqZ-QN5x94Iypj5UxIVjD-NB0o-qb0zOy41K0DWeDfE52bBRDo8ZRXpDLWh8YYyOX6iW5EKwfRib6Hfl5a5bGFwA6r9VGoKaAoTOYuhZwdHqks9knWIKlBWpOJlmgAWsh7ekBkWCXSvMRiomRougYjibS7OnBLAESNtfkoOzzJijGhQzzlGM4YTunDbQ55gJ2QZnd7AuNAf1wiMVUPFBfkRfexAqvn-4r8v325tv1l-b-6-e760_3jRWqxW90zPUKROek9NPUDW07TC3vle-980p417nBgnRY7mDqB-Gkc663KJLOGHFF3p99DyX_WKEueg7VQowmQV6rbrkapeikHBF99w_6kNeScLqN4rjdQQmk-JmyJddawOtDweWVR82Z3iLU5wg1Rqi3CPUJNW-fnNdpBvdH8TszBNozULGV9lD-Pv1_118JUqyy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2171890873</pqid></control><display><type>article</type><title>Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><creator>Faron, Anton ; Pieper, Claus C. ; Schmeel, Frederic C. ; Sprinkart, Alois M. ; Kuetting, Daniel L. R. ; Fimmers, Rolf ; Trebicka, Jonel ; Schild, Hans H. ; Meyer, Carsten ; Thomas, Daniel ; Luetkens, Julian A.</creator><creatorcontrib>Faron, Anton ; Pieper, Claus C. ; Schmeel, Frederic C. ; Sprinkart, Alois M. ; Kuetting, Daniel L. R. ; Fimmers, Rolf ; Trebicka, Jonel ; Schild, Hans H. ; Meyer, Carsten ; Thomas, Daniel ; Luetkens, Julian A.</creatorcontrib><description>Objectives
To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with
90
Yttrium microspheres.
Methods
Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm
2
in men and 2825 mm
2
in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed.
Results
Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days,
p
= 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652;
p
< 0.001). Baseline bilirubin (HR 1.875;
p
= 0.030), pattern of tumor manifestation (HR 1.679;
p
= 0.001), and model of endstage liver disease (MELD) score (HR 1.164;
p
< 0.001) were also significantly associated with OS.
Conclusions
FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis.
Key Points
• Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization.
• FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging.
• FFMA might be a new promising biomarker for assessment of sarcopenia.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-018-5976-z</identifier><identifier>PMID: 30689036</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adipose tissue ; Aged ; Aged, 80 and over ; Bilirubin ; Biomarkers ; Brachytherapy - methods ; Cancer ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - pathology ; Diagnostic Radiology ; Fat-free ; Female ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Liver ; Liver cancer ; Liver diseases ; Liver Neoplasms - radiotherapy ; Liver Neoplasms - secondary ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical imaging ; Medical prognosis ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Microspheres ; Middle Aged ; Muscle, Skeletal - diagnostic imaging ; Muscles ; Neuroradiology ; NMR ; Nuclear magnetic resonance ; Oncology ; Patients ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Radiology ; Regression analysis ; Resonance ; Retrospective Studies ; Sarcopenia ; Survival ; Survival Analysis ; Ultrasound ; Yttrium Radioisotopes - therapeutic use</subject><ispartof>European radiology, 2019-09, Vol.29 (9), p.4709-4717</ispartof><rights>European Society of Radiology 2019</rights><rights>European Radiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-f50d67e35d44fbb58228b2167f6fdf73fd5d8ce4d28b5eb683d4ddd6c67e4daa3</citedby><cites>FETCH-LOGICAL-c372t-f50d67e35d44fbb58228b2167f6fdf73fd5d8ce4d28b5eb683d4ddd6c67e4daa3</cites><orcidid>0000-0002-7715-4636</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-018-5976-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-018-5976-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30689036$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Faron, Anton</creatorcontrib><creatorcontrib>Pieper, Claus C.</creatorcontrib><creatorcontrib>Schmeel, Frederic C.</creatorcontrib><creatorcontrib>Sprinkart, Alois M.</creatorcontrib><creatorcontrib>Kuetting, Daniel L. R.</creatorcontrib><creatorcontrib>Fimmers, Rolf</creatorcontrib><creatorcontrib>Trebicka, Jonel</creatorcontrib><creatorcontrib>Schild, Hans H.</creatorcontrib><creatorcontrib>Meyer, Carsten</creatorcontrib><creatorcontrib>Thomas, Daniel</creatorcontrib><creatorcontrib>Luetkens, Julian A.</creatorcontrib><title>Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with
90
Yttrium microspheres.
Methods
Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm
2
in men and 2825 mm
2
in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed.
Results
Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days,
p
= 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652;
p
< 0.001). Baseline bilirubin (HR 1.875;
p
= 0.030), pattern of tumor manifestation (HR 1.679;
p
= 0.001), and model of endstage liver disease (MELD) score (HR 1.164;
p
< 0.001) were also significantly associated with OS.
Conclusions
FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis.
Key Points
• Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization.
• FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging.
• FFMA might be a new promising biomarker for assessment of sarcopenia.</description><subject>Adipose tissue</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bilirubin</subject><subject>Biomarkers</subject><subject>Brachytherapy - methods</subject><subject>Cancer</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Diagnostic Radiology</subject><subject>Fat-free</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver diseases</subject><subject>Liver Neoplasms - radiotherapy</subject><subject>Liver Neoplasms - secondary</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Microspheres</subject><subject>Middle Aged</subject><subject>Muscle, Skeletal - diagnostic imaging</subject><subject>Muscles</subject><subject>Neuroradiology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Oncology</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Resonance</subject><subject>Retrospective Studies</subject><subject>Sarcopenia</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Ultrasound</subject><subject>Yttrium Radioisotopes - therapeutic use</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kcGKFDEQhoMo7uzqA3iRgBcvrUkn3ek-yrKrCwte9BzSSWXIkk7GpHtg53l8UKuZVUEQAoGq7_9TqZ-QN5x94Iypj5UxIVjD-NB0o-qb0zOy41K0DWeDfE52bBRDo8ZRXpDLWh8YYyOX6iW5EKwfRib6Hfl5a5bGFwA6r9VGoKaAoTOYuhZwdHqks9knWIKlBWpOJlmgAWsh7ekBkWCXSvMRiomRougYjibS7OnBLAESNtfkoOzzJijGhQzzlGM4YTunDbQ55gJ2QZnd7AuNAf1wiMVUPFBfkRfexAqvn-4r8v325tv1l-b-6-e760_3jRWqxW90zPUKROek9NPUDW07TC3vle-980p417nBgnRY7mDqB-Gkc663KJLOGHFF3p99DyX_WKEueg7VQowmQV6rbrkapeikHBF99w_6kNeScLqN4rjdQQmk-JmyJddawOtDweWVR82Z3iLU5wg1Rqi3CPUJNW-fnNdpBvdH8TszBNozULGV9lD-Pv1_118JUqyy</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Faron, Anton</creator><creator>Pieper, Claus C.</creator><creator>Schmeel, Frederic C.</creator><creator>Sprinkart, Alois M.</creator><creator>Kuetting, Daniel L. R.</creator><creator>Fimmers, Rolf</creator><creator>Trebicka, Jonel</creator><creator>Schild, Hans H.</creator><creator>Meyer, Carsten</creator><creator>Thomas, Daniel</creator><creator>Luetkens, Julian A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7715-4636</orcidid></search><sort><creationdate>20190901</creationdate><title>Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases</title><author>Faron, Anton ; Pieper, Claus C. ; Schmeel, Frederic C. ; Sprinkart, Alois M. ; Kuetting, Daniel L. R. ; Fimmers, Rolf ; Trebicka, Jonel ; Schild, Hans H. ; Meyer, Carsten ; Thomas, Daniel ; Luetkens, Julian A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-f50d67e35d44fbb58228b2167f6fdf73fd5d8ce4d28b5eb683d4ddd6c67e4daa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adipose tissue</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bilirubin</topic><topic>Biomarkers</topic><topic>Brachytherapy - methods</topic><topic>Cancer</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Diagnostic Radiology</topic><topic>Fat-free</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver diseases</topic><topic>Liver Neoplasms - radiotherapy</topic><topic>Liver Neoplasms - secondary</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Microspheres</topic><topic>Middle Aged</topic><topic>Muscle, Skeletal - diagnostic imaging</topic><topic>Muscles</topic><topic>Neuroradiology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Oncology</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Resonance</topic><topic>Retrospective Studies</topic><topic>Sarcopenia</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Ultrasound</topic><topic>Yttrium Radioisotopes - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Faron, Anton</creatorcontrib><creatorcontrib>Pieper, Claus C.</creatorcontrib><creatorcontrib>Schmeel, Frederic C.</creatorcontrib><creatorcontrib>Sprinkart, Alois M.</creatorcontrib><creatorcontrib>Kuetting, Daniel L. R.</creatorcontrib><creatorcontrib>Fimmers, Rolf</creatorcontrib><creatorcontrib>Trebicka, Jonel</creatorcontrib><creatorcontrib>Schild, Hans H.</creatorcontrib><creatorcontrib>Meyer, Carsten</creatorcontrib><creatorcontrib>Thomas, Daniel</creatorcontrib><creatorcontrib>Luetkens, Julian A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Faron, Anton</au><au>Pieper, Claus C.</au><au>Schmeel, Frederic C.</au><au>Sprinkart, Alois M.</au><au>Kuetting, Daniel L. R.</au><au>Fimmers, Rolf</au><au>Trebicka, Jonel</au><au>Schild, Hans H.</au><au>Meyer, Carsten</au><au>Thomas, Daniel</au><au>Luetkens, Julian A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>29</volume><issue>9</issue><spage>4709</spage><epage>4717</epage><pages>4709-4717</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To investigate the clinical potential of fat-free muscle area (FFMA) to predict outcome in patients with liver-predominant metastatic colorectal cancer (mCRC) undergoing radioembolization (RE) with
90
Yttrium microspheres.
Methods
Patients with mCRC who underwent RE in our center were included in this retrospective study. All patients received liver magnetic resonance imaging including standard T2-weighted images. The total erector spinae muscle area and the intramuscular adipose tissue area were measured at the level of the origin of the superior mesenteric artery and subtracted to calculate FFMA. Cutoff values for definition of low FFMA were 3644 mm
2
in men and 2825 mm
2
in women. The main outcome was overall survival (OS). For survival analysis, the Kaplan-Meier method and Cox regressions comparing various clinic-oncological parameters which potentially may affect OS were performed.
Results
Seventy-seven patients (28 female, mean age 60 ± 11 years) were analyzed. Mean time between MRI and the following RE was 17 ± 31 days. Median OS after RE was 178 days. Patients with low FFMA had significantly shortened OS compared to patients with high FFMA (median OS: 128 vs. 273 days,
p
= 0.017). On multivariate Cox regression analysis, OS was best predicted by FFMA (hazard ratio (HR) 2.652;
p
< 0.001). Baseline bilirubin (HR 1.875;
p
= 0.030), pattern of tumor manifestation (HR 1.679;
p
= 0.001), and model of endstage liver disease (MELD) score (HR 1.164;
p
< 0.001) were also significantly associated with OS.
Conclusions
FFMA was associated with OS in patients receiving RE for treatment of mCRC and might be a new prognostic biomarker for survival prognosis.
Key Points
• Fat-free muscle area (FFMA) as a measure of lean muscle area predicts survival in metastatic colorectal liver cancer following radioembolization.
• FFMA can easily be assessed from routine pre-interventional liver magnetic resonance imaging.
• FFMA might be a new promising biomarker for assessment of sarcopenia.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30689036</pmid><doi>10.1007/s00330-018-5976-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7715-4636</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2019-09, Vol.29 (9), p.4709-4717 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2179435449 |
| source | MEDLINE; SpringerLink (Online service) |
| subjects | Adipose tissue Aged Aged, 80 and over Bilirubin Biomarkers Brachytherapy - methods Cancer Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - pathology Diagnostic Radiology Fat-free Female Humans Imaging Internal Medicine Interventional Radiology Liver Liver cancer Liver diseases Liver Neoplasms - radiotherapy Liver Neoplasms - secondary Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical imaging Medical prognosis Medicine Medicine & Public Health Metastases Metastasis Microspheres Middle Aged Muscle, Skeletal - diagnostic imaging Muscles Neuroradiology NMR Nuclear magnetic resonance Oncology Patients Predictive Value of Tests Prognosis Proportional Hazards Models Radiology Regression analysis Resonance Retrospective Studies Sarcopenia Survival Survival Analysis Ultrasound Yttrium Radioisotopes - therapeutic use |
| title | Fat-free muscle area measured by magnetic resonance imaging predicts overall survival of patients undergoing radioembolization of colorectal cancer liver metastases |
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