CT‐based assessment of body composition following neoadjuvant chemohormonal therapy in patients with castration‐naïve oligometastatic prostate cancer

Abstract

Background The purpose of this study is to assess the body composition changes in men with recently diagnosed oligometastatic prostate cancer following neoadjuvant chemohormonal therapy. Further, we evaluated whether CT‐based body composition parameters are associated with biochemical recurrence or imaging progression. Material and methods Recently diagnosed castration‐naïve oligometastatic prostate cancer patients who received neoadjuvant docetaxel chemotherapy and androgen deprivation treatment (ADT) before prostatectomy and consolidation of local and oligometastatic disease (total eradication therapy), as part of a phase‐II prospective clinical trial were included. Body composition parameters including cross‐sectional areas of the psoas muscle, total, visceral, and subcutaneous adipose tissue were measured on serial CT scans obtained before and following completion of neoadjuvant treatment. Results A total of 22 prostate cancer patients were included (median age 58 years, median Gleason score 8). The median time intervals between commencement of neoadjuvant chemohormonal therapy and first and second follow‐up CTs were 3 and 12 months, respectively. Compared to the baseline scan, there were significant declines in psoas muscle cross‐sectional areas with estimated percentage declines of −13.9% (IQR: 7.6%–16.5%, p < .001) and −13.2% (IQR: 6%–11.2%, p < .001) on first and second follow‐up CTs. There were significant increases in subcutaneous adipose tissue following neoadjuvant chemohormonal therapy with percentage increases of +8.9% (IQR: 5.1%–21.5%, p = .002) and +18.9% (IQR: 6.1%–33.8%, p < .001), respectively. The median follow‐up was 34.5 months. The estimated 2‐year prostate‐specific antigen progression‐free and radiologic progression‐free survival were 95.5%. No significant association between baseline or percentage change in body composition parameters and disease progression were identified. Conclusions Our findings showed a significant reduction in muscle mass and an increase in subcutaneous adiposity in men treated with neoadjuvant docetaxel and ADT, more pronounced on the first follow‐up scan after completion of neoadjuvant treatment. Body composition parameters were not found to be significant predictors of disease progression in our cohort.

Influence of Androgen Deprivation Therapy on the Development of Sarcopenia in Patients with Prostate Cancer: A Systematic Review

“…The description of included studies is presented in Table 1 . Observational studies were conducted in ethnically diverse groups of PCa patients, where the sarcopenia was assessed either twice (at the baseline and in the follow up) [ 22 , 23 , 25 , 26 , 27 ] or only once during the ADT treatment [ 28 , 29 ]. The largest group of PCa patients was found in Chiang et al [ 25 ] and therefore this study will have the greatest impact on the meta-analysis performed.…”

“…In most of the PCa patients, the median Gleason score was 8, indicating high-grade cancer ( Table 2 ). Patients were on different treatment regimens using ADT, where the ADT duration was reported in four studies [ 26 , 27 , 28 , 29 ] and dietary counselling was incorporated in the treatment in only one study [ 22 ] ( Table 3 ). Taking into account selected body composition parameters, an increase in SATI and VATI with a decrease in SMI and SMD over the course of ADT was observed ( Table 4 ).…”

Impact of Body Composition During Neoadjuvant Chemoradiotherapy on Complications, Survival and Tumor Response in Patients With Locally Advanced Rectal Cancer

“…Sheikhbahaei et al reported that prostate cancer patients suffer from a significant reduction in muscle mass and an increase in subcutaneous adiposity during NCRT (29). Interestingly, no apparent change in body composition was observed in our study, which is consistent with the findings of Chung et al's and De Recently, a study of 1,630 stage I to III colon cancer patients indicated that low SMA and low MD were associated with a longer length of stay and a higher risk of postsurgical complications (31).…”

Radiomics in Nasopharyngeal Carcinoma

“…CT-based body composition information has been used as healthy and prognostic indicators in prostate cancer. 66 This method can be extended to patients with NPC. It can be used to identify patients at risk of malnutrition.…”