Kusunoki Yukina, Fukuoka Tatsunari, Sugimoto Atsushi, Tsujio Gen, Yonemitsu Ken, Seki Yuki, Kasashima Hiroaki, Shibutani Masatsune, Maeda Kiyoshi
Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Cancer Diagn Progn. 2025 Jan 3;5(1):72-82. doi: 10.21873/cdp.10414. eCollection 2025 Jan-Feb.
BACKGROUND/AIM: Reduction in skeletal muscle mass during chemotherapy is associated with poor outcomes. This study investigated the impact of changes in the psoas muscle index (PMI) on the prognosis of patients with unresectable colorectal liver metastases (CRLM) undergoing chemotherapy, including subgroup analyses based on the initial treatment response assessment.
We evaluated 47 patients with unresectable CRLM who underwent systematic chemotherapy and assessed changes in PMI to determine their prognosis.
Changes in PMI were significantly associated with the presence or absence of primary tumor resection and the chemotherapeutic responses to first-line chemotherapy. The PMI reduction group was significantly associated with poor prognosis in both overall survival (OS) and progression-free survival (PFS) in patients with CRLM, and in both OS and PFS in the partial response (PR) group at the initial chemotherapy response assessment.
Skeletal muscle loss at chemotherapy initiation was significantly associated with poorer survival in patients with unresectable CRLM. Maintaining muscle mass could serve as a new indicator for identifying patients with a PR at the initial chemotherapy response assessment for prognosis. Personalized interventions should be investigated to determine whether they can improve muscle mass and lead to better clinical outcomes.
背景/目的:化疗期间骨骼肌质量的减少与不良预后相关。本研究调查了腰大肌指数(PMI)变化对接受化疗的不可切除结直肠癌肝转移(CRLM)患者预后的影响,包括基于初始治疗反应评估的亚组分析。
我们评估了47例接受系统化疗的不可切除CRLM患者,并评估PMI的变化以确定其预后。
PMI的变化与原发肿瘤切除的有无以及一线化疗的化疗反应显著相关。在CRLM患者的总生存期(OS)和无进展生存期(PFS)以及初始化疗反应评估时部分缓解(PR)组的OS和PFS中,PMI降低组均与不良预后显著相关。
化疗开始时骨骼肌丢失与不可切除CRLM患者较差的生存率显著相关。维持肌肉质量可作为在初始化疗反应评估时识别PR患者预后的新指标。应研究个性化干预措施,以确定它们是否能改善肌肉质量并带来更好的临床结果。