Skeletal muscle measurements predict surgical wound complications but not overall survival in patients with soft tissue sarcoma

Abstract

Background It is unknown whether sarcopenia influences treatment outcome in patients with soft tissue sarcoma. Herein, we aimed to elucidate the impact of sarcopenia on sarcoma treatment. Methods A total of 163 soft tissue sarcoma patients were included. Skeletal muscle measures were calculated using computed tomography images. Skeletal muscle area (SMA) and density (SMD) at the L3 level were extracted, and SMA was normalized by height as skeletal muscle index (SMI). The skeletal muscle gauge (SMG) was calculated by multiplying SMD × SMI. The relationship of skeletal muscle measures and clinical factors to wound complications and prognosis was evaluated, and classification and regression tree (CART) analysis was used to develop classification models for risk groups of surgical wound complications. Results Thirty-three patients developed wound complications. In univariate analysis, age (P = 0.0022), tumour location of adductor compartment of the thigh (P = 0.0019), operating time (P = 0.010), blood loss (P = 0.030), SMD (P = 0.0004) and SMG (P = 0.0001) were significantly correlated with complications. In multivariate analysis, lower SMG was an independent risk factor (P = 0.031, OR = 3.27). CART analysis classified three risk groups of surgical wound complications by SMG, age, tumour location and operating time, and area under the receiver operating characteristic curve (AUROCC) was 0.75. SMG was not associated with prognosis in univariate analysis (P = 0.15). Conclusions The SMG does not affect overall survival but predicts surgical wound complications.

Skeletal muscle gauge as a prognostic factor in patients with colorectal cancer

“…These previous studies investigated the clinical significance of SMG in female patients with cancer; the studies had relatively small sample sizes; thus, comparison of the mean or median SMG values between the sexes has been scarcely reported. Hirai et al reported that the mean SMG value was higher in men than in women (1729 AU vs. 1343 AU, p < 0.0001) who underwent surgeries for soft tissue sarcoma 28 . Consistent with this result, our cohort showed a higher median SMG value in the male patients than in the female patients both in the training and test sets.…”

“…Hirai et al reported that the mean SMG value was higher in men than in women (1729 AU vs. 1343 AU, p < 0.0001) who underwent surgeries for soft tissue sarcoma. 28 Consistent with this result, our cohort showed a higher median SMG value in the male patients than in the female patients both in the training and test sets. Thus, we decided to define sex-specific cutoff SMG values and confirmed that this newly developed stratification could be used as a significant prognostic factor even in an independent cohort.…”

Prevalence of Low Muscle Mass in the Computed Tomography at the Third Lumbar Vertebra Level Depends on Chosen Cut-Off in 200 Hospitalised Patients—A Prospective Observational Trial

“…First, statistical calculation of the cut-offs was different: cut-offs were calculated either as mean-2 SD [8], median [9], a percentile [10][11][12] or as a predictor for a cut-off of another imaging method (dual-energy X-ray absorptiometry (DXA) [13]), as a predictor for wound complication [14], likelihood of tumour resection [15], mortality [3] or length of stay [16]. Second, adjustment of the cut-offs was different: sometimes, SMA was nonadjusted and expressed in cm 2 [6,8].…”