Cited by 149Nutrition and Health in AgingBody Composition Measurement TechniquesSarcoma Diagnosis and Treatment

Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy

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Rier, Hánah N., Jager, Agnes, Sleijfer, Stefan, van Rosmalen, Joost, Kock, Marc C.J.M., Levin, Mark-David·2017·The Breast

Abstract

Background Low muscle mass (LMM) and low muscle attenuation (LMA) reflect low muscle quantity and low muscle quality, respectively. Both are associated with a poor outcome in several types of solid malignancies. This study determined the association of skeletal muscle measures with overall survival (OS) and time to next treatment (TNT). Patients and methods A skeletal muscle index (SMI) in cm 2 /m 2 and muscle attenuation (MA) in Hounsfield units (HU) were measured using abdominal CT-images of 166 patients before start of first-line chemotherapy for metastatic breast cancer. Low muscle mass (SMI <41 cm 2 /m 2 ), sarcopenic obesity (LMM and BMI ≥30 kg/m 2 ) and low muscle attenuation (MA <41 HU and BMI <25 kg/m2 or MA <33 HU and BMI ≥25 kg/m2) were related to OS and TNT. Results The prevalence of LMM, sarcopenic obesity and LMA were 66.9%, 7.2% and 59.6% respectively. LMM and sarcopenic obesity showed no significant association with OS and TNT, whereas LMA was associated with both lower OS (HR 2.04, 95% CI 1.34–3.12, p = 0.001) and shorter TNT (HR 1.72, 95% CI 1.14–2.62, p = 0.010). Patients with LMA had a median OS and TNT of 15 and 8 months respectively, compared to 23 and 10 months in patients with normal MA. Conclusion LMA is a prognostic factor for OS and TNT in metastatic breast cancer patients receiving first-line palliative chemotherapy, whereas LMM and sarcopenic obesity are not. Further research is needed to establish what impact LMA should have in daily clinical practice.

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  1. Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Rep Int Sarcopenia Initiat. EWGSOP IWGS 2014;43:748e59.

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Authors
Rier, H. N., Jager, A., Sleijfer, S., van Rosmalen, J., Kock, M. C. J. M., & Levin, M.-D.
Affiliations
  • Albert Schweitzer Ziekenhuis (NL)
  • Erasmus MC Cancer Institute (NL)
Corresponding author
Rier, Hánah N.
Venue
The Breast
Publisher
Elsevier BV
Published
2017-02
Volume
31
Pages
9-15
ISSN
0960-9776 (ISSN-L)
OpenAlex
W2540033076
Cited by
149
References
42
Citations by year
2026: 6 · 2025: 9 · 2024: 20 · 2023: 14 · 2022: 18 · 2021: 25 · 2020: 20 · 2019: 16 · 2018: 16 · 2017: 5
FWCI
9.94
Type
journal article
Language
en
Open access
Locations
  • The Breast (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
Keywords
metastatic breast cancer, skeletal muscle index, sarcopenic obesity, low muscle mass, prognostic factors, overall survival, time to next treatment, palliative chemotherapy, skeletal muscle quality, sarcopenia
MeSH terms
Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Female, Humans, Middle Aged, Muscular Atrophy, Neoplasm Metastasis, Netherlands, Palliative Care, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Prevalence, Muscle, Skeletal

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