Ibilibor C, Wang H, Kaushik D, Rodriguez R
Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
JAR Life. 2021 Jun 28;10:45-49. doi: 10.14283/jarlife.2021.8. eCollection 2021.
Low skeletal muscle mass determined radiographically has emerged as an important prognostic marker in penile cancer patients but may be unrecognized in obese patients with a high comorbid disease burden. Moreover, publicly available software for image segmentation are limited. Thus, we describe the prevalence of radiographically low skeletal muscle mass in an obese penile cancer cohort, using an open-source software and examine its association with comorbid disease burden.
This is a cross-sectional study, utilizing retrospective data from patients diagnosed with penile squamous cell carcinoma between October 2009 and December 2019. Available digital files of perioperative computerized tomography were analyzed, using CoreSlicer, an open-source image segmentation software. The correlation between radiographically low skeletal muscle mass, defined as a skeletal muscle index (SMI) less than 55 cm2/m2 and a Charlson Comorbidity Index (CCI) greater than 4 was examined, using logistic and linear regression.
Forty two of 59 patients had available digital files. Median SMI and body mass index (BMI) were 54.6cm2/m2 and 30.2kg/m2 respectively for the entire cohort. Of included patients, 54% had radiographically low skeletal muscle mass and a median BMI of 28.9 kg/m2. Radiographically low skeletal muscle mass was associated with a CCI greater than 4 on univariable and multivariable logistic regression with odds ratios of 4.85 (p = 0.041) and 7.32 (p = 0.033), respectively. When CCI was treated as a continuous variable on linear regression, the association between radiographically low skeletal muscle mass and CCI was positive, but not statistically significant with an estimated effect of 1.29 (p = 0.1) and 1.27 (p = 0.152) on univariable and multivariable analysis, respectively.
Our data demonstrate that low skeletal muscle mass can be readily assessed with CoreSlicer and is associated with a CCI greater than 4 in obese penile cancer patients.
影像学检查确定的低骨骼肌质量已成为阴茎癌患者重要的预后标志物，但在合并症负担高的肥胖患者中可能未被认识到。此外，公开可用的图像分割软件有限。因此，我们使用开源软件描述肥胖阴茎癌队列中影像学检查显示低骨骼肌质量的患病率，并研究其与合并症负担的关联。
这是一项横断面研究，利用2009年10月至2019年12月期间诊断为阴茎鳞状细胞癌的患者的回顾性数据。使用开源图像分割软件CoreSlicer分析围手术期计算机断层扫描的可用数字文件。使用逻辑回归和线性回归检查影像学检查显示的低骨骼肌质量（定义为骨骼肌指数[SMI]小于55 cm2/m2）与Charlson合并症指数（CCI）大于4之间的相关性。
59例患者中有42例有可用数字文件。整个队列的SMI中位数和体重指数（BMI）分别为54.6cm2/m2和30.2kg/m2。纳入的患者中，54%有影像学检查显示的低骨骼肌质量，BMI中位数为28.9 kg/m2。在单变量和多变量逻辑回归中，影像学检查显示的低骨骼肌质量与CCI大于4相关，比值比分别为4.85（p = 0.041）和7.32（p = 0.033）。在线性回归中将CCI视为连续变量时，影像学检查显示的低骨骼肌质量与CCI之间的关联为正，但无统计学意义，单变量和多变量分析的估计效应分别为1.29（p = 0.1）和1.27（p = 0.152）。
我们的数据表明，使用CoreSlicer可以轻松评估低骨骼肌质量，且在肥胖阴茎癌患者中与CCI大于4相关。
