Body composition and metastatic prostate cancer survivorship

Coletta, Adriana M.; Sayegh, Nicolas; Agarwal, Neeraj

doi:10.1016/j.ctarc.2021.100322

Cited by 7 publications

(11 citation statements)

References 28 publications

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“…These strategies may include exercise, diet, or a combination. Aerobic and resistance exercise training, regardless of weight loss or dietary changes, can facilitate attenuation of central obesity, specifically visceral fat (102,103). Subsequently, reductions in central obesity and visceral fat promote improvements in insulin sensitivity, inflammation, angiogenesis, and tumorigenesis (102,104).…”

Section: Discussionmentioning

confidence: 99%

“…Aerobic and resistance exercise training, regardless of weight loss or dietary changes, can facilitate attenuation of central obesity, specifically visceral fat (102,103). Subsequently, reductions in central obesity and visceral fat promote improvements in insulin sensitivity, inflammation, angiogenesis, and tumorigenesis (102,104). Along with reductions in central obesity, exercise releases cytokines from contracting skeletal muscle (myokines) that have autocrine and endocrine effects on metabolic health, reducing inflammation and promoting whole‐body insulin sensitivity (102).…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Metabolic dysfunction and obesity‐related cancer: Beyond obesity and metabolic syndrome

Karra

Winn

Pauleck

et al. 2022

Obesity

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Objectives: The metabolic dysfunction driven by obesity, including hyperglycemia and dyslipidemia, increases risk for developing at least 13 cancer types. The concept of “metabolic dysfunction” is often defined by meeting various combinations of criteria for metabolic syndrome. However, the lack of a unified definition of metabolic dysfunction makes it difficult to compare findings across studies. This review summarizes 129 studies that evaluated variable definitions of metabolic dysfunction in relation to obesity‐related cancer risk and mortality after a cancer diagnosis. Strategies for metabolic dysfunction management are also discussed.MethodsA comprehensive search of relevant publications in MEDLINE (PubMed) and Google Scholar with review of references was conducted.ResultsMetabolic dysfunction, defined as metabolic syndrome diagnosis or any number of metabolic syndrome criteria out of clinical range, inflammatory biomarkers, or markers of metabolic organ function, has been associated with risk for, and mortality from, colorectal, pancreatic, postmenopausal breast, and bladder cancers. Metabolic dysfunction associations with breast and colorectal cancer risk have been observed independently of BMI, with increased risk in individuals with metabolically unhealthy normal weight or overweight/obesity compared with metabolically healthy normal weight.ConclusionMetabolic dysfunction is a key risk factor for obesity‐related cancer, regardless of obesity status. Nonetheless, a harmonized definition of metabolic dysfunction will further clarify the magnitude of the relationship across cancer types, enable better comparisons across studies, and further guide criteria for obesity‐related cancer risk stratification.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Metabolic dysfunction and obesity‐related cancer: Beyond obesity and metabolic syndrome

Karra

Winn

Pauleck

et al. 2022

Obesity

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“…Within the broader context of metastatic cancer, these conditions have emerged as predictors of chemotherapy toxicity, shorter time to tumor progression (TTP), and decreased overall survival (OS) [ 15 ]. Evidence from a recent review on body composition in the MPC setting [ 16 ] supports associations between low levels of SM, increased disease progression, and shorter OS for men with MPC on antiandrogen therapies [ 17 – 19 ] and on single-agent chemotherapy [ 20 – 22 ]. Simultaneously, Xu et al report that high body mass index (BMI) predicts longer survival in men with MPC, independent of sarcopenia or myosteatosis [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features and Body Composition in Men with Hormone-Sensitive Metastatic Prostate Cancer: A Pilot Study Examining Differences by Race

et al. 2022

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Black men treated with frontline therapies for metastatic prostate cancer (MPC) show better clinical outcomes than non-Black men receiving similar treatments. Variations in body composition may contribute to these findings. However, preliminary data are required to support this concept. We conducted a retrospective cohort study for all men with MPC evaluated at our center over a 4-year period, collecting demographic and clinical data (N = 74). Of these, 55 men had diagnostic computed tomography images to quantify adipose tissue and skeletal muscle, specifically sarcopenia and myosteatosis. Nineteen men had repeat imaging to explore changes over time. Frequencies, medians, interquartile ranges, and time to event analyses (hazard ratios (HR); confidence interval (CI)) are presented, stratified by race. Overall, 49% (n = 27) of men had sarcopenia, 49% (n = 27) had myosteatosis, and 29% (n = 16) had sarcopenia and myosteatosis simultaneously. No significant relationship between body mass index (Log-rank p = 0.86 ; HR: 1.05, 95% CI: 0.45–2.49) or sarcopenia (Log-rank p = 0.92 ; HR: 1.01, 95% CI: 0.46–2.19) and overall survival was observed. However, the presence of myosteatosis at diagnosis was associated with decreased overall survival (Log-rank p = 0.09 ; HR: 2.34, 95% CI: 1.05–5.23), with more pronounced (statistically nonsignificant) negative associations for Black (HR: 4.39, 95% CI: 0.92–21.1, p = 0.06 ) versus non-Black men (HR: 1.89, 95% CI: 0.79–4.54, p = 0.16 ). Over the median 12.5 months between imaging, the median decline in skeletal muscle was 4% for all men. Black men displayed a greater propensity to gain more adipose tissue than non-Black men, specifically subcutaneous ( p = 0.01 ). Because of the potential for Type II errors in this pilot, future studies should seek to further evaluate the implications of body composition on outcomes. This will require larger, adequately powered investigations with diverse patient representation.

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“…The association between body composition and outcomes has been investigated in cancers including colorectal, 13 breast, 14 gastrointestinal 15 and prostate. 16 However, differences in the body composition of patients have not been compared across cancer types, and differences in outcomes related to body composition between cancer types are not well defined.…”

Section: Introductionmentioning

confidence: 99%

Assessment of body composition and association with clinical outcomes in patients with lung and colorectal cancer

et al. 2021

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Objectives: To assess body composition in patients with non-small cell lung cancer (NSCLC) and colorectal cancer using whole-body MRI and relate this to clinical outcomes. Methods: 53 patients with NSCLC (28 males, 25 females; mean age 66.9) and 74 patients with colorectal cancer (42 males, 32 females; mean age 62.9) underwent staging whole-body MRI scans, which were post-processed to derive fat mass (FM), fat free mass (FFM) and skeletal muscle (SM) indices and SM fat fraction (FF). These were compared between the two cancer cohorts using two-sided t-tests and the chi-squared test. Measurements of body composition were correlated with outcomes including length of hospital stay, metastatic status and mortality. Results: Patients with NSCLC had significantly lower FFM (p = 0.0071) and SM (p = 0.0084) indices. Mean SM FF was greater in patients with NSCLC (p = 0.0124) and was associated with longer hospital stay (p = 0.035). There was no significant relationship between FM, FFM and SM indices and length of hospital stay, metastatic status or mortality. Conclusions: Patients with NSCLC had lower FFM and SM indices than patients with colorectal cancer and greater SMFF, indicating lower SM mass with fatty infiltration. These findings reflect differences in the phenotype of the two groups and suggest patients with lung cancer are more likely to require additional nutritional support. Advances in knowledge: Body composition differs between NSCLC and colorectal cancer. Patients with NSCLC have both a reduced SM mass and greater SM FF suggesting that they are more nutritionally deplete than patients with colorectal cancer.

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Body composition and metastatic prostate cancer survivorship

Cited by 7 publications

References 28 publications

Metabolic dysfunction and obesity‐related cancer: Beyond obesity and metabolic syndrome

Metabolic dysfunction and obesity‐related cancer: Beyond obesity and metabolic syndrome

Clinical Features and Body Composition in Men with Hormone-Sensitive Metastatic Prostate Cancer: A Pilot Study Examining Differences by Race

Assessment of body composition and association with clinical outcomes in patients with lung and colorectal cancer

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