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Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy
Open accessAbstract
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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“reported associations indicate a stronger link of muscle fat with adverse outcomes as compared with muscle quantity.60,61,[65][66][67]”
From Changes in lean body mass with glucagon‐like peptide ‐1‐based therapies and mitigation strategies (2024) · cites this paper as [66]
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Metadata
- 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)
- Erasmus MC (NL)
- Corresponding author
- Rier, Hánah N.
- ORCID
- 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
- hybrid
- doi.org
- Licence
- 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 (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Medicine › Oncology › 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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