CHA University School of Medicine, 120 Hyeryong-ro, Pocheon-si, Gyeonggi-do, 11160, Republic of Korea.
Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13488, Republic of Korea.
Sci Rep. 2024 Oct 7;14(1):23309. doi: 10.1038/s41598-024-74060-w.
Breast cancer remains a significant public health issue, often resulting in severe side effects such as neutropenia, highlighting the need for reliable predictors of clinical outcomes. This study aimed to evaluate the predictive value of body composition measures for mortality, recurrence, and chemotherapy-induced neutropenia in patients with breast cancer following surgery and chemotherapy. We retrospectively analyzed 85 breast cancer patients who underwent surgery and chemotherapy between 2006 and 2016. Body composition was assessed using computed tomography (CT) or positron emission tomography (PET) at diagnosis and three years and five years post-diagnosis. Metrics included skeletal muscle area (SMA), skeletal muscle index (SMI), subcutaneous adipose tissue area (SAT), and visceral adipose tissue area (VAT). Longitudinal analysis revealed a decrease in muscle mass (P < 0.001 for both SMA and SMI) and nonsignificant changes in fat mass (P = 0.449 for SAT and P = 0.798 for VAT). A lower SMI at diagnosis was significantly associated with increased mortality (P = 0.019) and a higher incidence of grade 4 neutropenia (P = 0.008). There was no significant association between SMI at diagnosis and recurrence (P = 0.691). No associations were found between body composition measurements during the follow-up period and the clinical outcomes. Lower skeletal muscle mass at diagnosis is strongly associated with higher mortality and chemotherapy-induced complications in patients with breast cancer, highlighting the potential of readily available imaging techniques as valuable predictors of clinical outcomes.
乳腺癌仍然是一个重大的公共卫生问题,常导致中性粒细胞减少等严重副作用,突出了对临床结局可靠预测指标的需求。本研究旨在评估体成分测量在乳腺癌患者手术后和化疗后对死亡率、复发和化疗诱导的中性粒细胞减少的预测价值。我们回顾性分析了 85 例 2006 年至 2016 年间接受手术和化疗的乳腺癌患者。在诊断时和诊断后三年和五年使用计算机断层扫描(CT)或正电子发射断层扫描(PET)评估体成分。指标包括骨骼肌面积(SMA)、骨骼肌指数(SMI)、皮下脂肪组织面积(SAT)和内脏脂肪组织面积(VAT)。纵向分析显示肌肉量减少(SMA 和 SMI 均 P < 0.001),脂肪量无明显变化(SAT P = 0.449,VAT P = 0.798)。诊断时较低的 SMI 与死亡率增加显著相关(P = 0.019),4 级中性粒细胞减少的发生率更高(P = 0.008)。诊断时的 SMI 与复发无显著相关性(P = 0.691)。在随访期间,体成分测量与临床结局之间没有显著关联。诊断时骨骼肌量较低与乳腺癌患者死亡率和化疗诱导的并发症增加密切相关,这突显了易于获得的影像学技术作为临床结局有价值预测指标的潜力。