Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M4-B402, Seattle, WA 98109-1024, USA.
J Cancer Surviv. 2012 Dec;6(4):398-406. doi: 10.1007/s11764-012-0234-x. Epub 2012 Oct 4.
This study aimed to determine the prevalence of sarcopenia and examine whether sarcopenia was associated with overall and breast-cancer-specific mortality in a cohort of women diagnosed with breast cancer (stages I-IIIA).
A total of 471 breast cancer patients from western Washington State and New Mexico who participated in the prospective Health, Eating, Activity, and Lifestyle Study were included in this study. Appendicular lean mass was measured using dual X-ray absorptiometry scans at study inception, on average, 12 months after diagnosis. Sarcopenia was defined as two standard deviations below the young healthy adult female mean of appendicular lean mass divided by height squared (<5.45 kg/m(2)). Total and breast-cancer-specific mortality data were obtained from Surveillance Epidemiology and End Results registries. Multivariable Cox proportional hazard models assessed the associations between sarcopenia and mortality.
Median follow-up was 9.2 years; 75 women were classified as sarcopenic, and among 92 deaths, 46 were attributed to breast cancer. In multivariable models that included age, race-ethnicity/study site, treatment type, comorbidities, waist circumference, and total body fat percentage, sarcopenia was independently associated with overall mortality (hazard ratio (HR) = 2.86; 95 % CI, 1.67-4.89). Sarcopenic women had increased risk of breast-cancer-specific mortality, although the association was not statistically significant (HR = 1.95, 95 % CI, 0.87-4.35).
Sarcopenia is associated with an increased risk of overall mortality in breast cancer survivors and may be associated with breast-cancer-specific mortality. The development of effective interventions to maintain and/or increase skeletal muscle mass to improve prognosis in breast cancer survivors warrants further study.
Such interventions may help breast cancer patients live longer.
本研究旨在确定局限性骨髓瘤的流行率，并在一组诊断为局限性骨髓瘤（I-IIIA 期）的女性队列中检查其与总体和局限性骨髓瘤特异性死亡率的关系。
本研究纳入了来自华盛顿州西部和新墨西哥州的 471 名局限性骨髓瘤患者，他们参加了前瞻性的健康、饮食、活动和生活方式研究。在研究开始时，通过双能 X 线吸收法扫描测量四肢瘦体重，平均在诊断后 12 个月。局限性骨髓瘤定义为四肢瘦体重除以身高的平方低于年轻健康成年女性平均值的两个标准差（<5.45kg/m²）。总死亡率和局限性骨髓瘤特异性死亡率数据来自监测、流行病学和最终结果登记处。多变量 Cox 比例风险模型评估了局限性骨髓瘤与死亡率之间的关系。
中位随访时间为 9.2 年；75 名女性被归类为局限性骨髓瘤，92 例死亡中，46 例归因于局限性骨髓瘤。在包括年龄、种族/研究地点、治疗类型、合并症、腰围和总体体脂百分比的多变量模型中，局限性骨髓瘤与总体死亡率独立相关（风险比（HR）=2.86；95%置信区间，1.67-4.89）。局限性骨髓瘤女性的局限性骨髓瘤特异性死亡率风险增加，尽管这种关联没有统计学意义（HR=1.95，95%置信区间，0.87-4.35）。
局限性骨髓瘤与乳腺癌幸存者的总体死亡率增加相关，并且可能与局限性骨髓瘤特异性死亡率相关。进一步研究开发有效的干预措施来维持和/或增加骨骼肌质量以改善乳腺癌幸存者的预后是必要的。
这些干预措施可能有助于乳腺癌患者活得更长。
