scholarly journals Association between CT-Measured Abdominal Skeletal Muscle Mass and Pulmonary Function

2019 ◽  
Vol 8 (5) ◽  
pp. 667 ◽  
Author(s):  
Eun Kyung Choe ◽  
Young Lee ◽  
Hae Yeon Kang ◽  
Seung Ho Choi ◽  
Joo Sung Kim
Keyword(s):  
Skeletal Muscle ◽  
Lung Function ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lumbar Vertebrae ◽  
Forced Expiratory Volume ◽  
The Body ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Clinical Records

A relationship between lung function and sarcopenia has been suggested. This study aimed to evaluate the association between lung function and abdominal skeletal muscle mass, as measured by computed tomography (CT). The clinical records of 1907 subjects (1406 males, mean age 53.1 ± 9.2 years), who underwent routine health check-ups, including spirometry and abdominal CT, were retrospectively reviewed. The CT-measured skeletal muscle index (SMICT, cm2/(kg/m2) was defined as the skeletal muscle area of the third lumbar vertebrae (L3) level that is normalized by the body mass index. The mean values of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) gradually increased as the SMICT quartiles increased (all p for trend < 0.05). The proportions of subjects with less than 80% of the predicted FVC (%) and predicted FEV1 (%) significantly decreased as the SMICT quartiles increased (all p for trend < 0.05). The β regression coefficients for FVC and FEV1 significantly increased as the SMICT quartiles increased after adjusting for other confounding variables (p for trend < 0.05). This study showed that abdominal muscle mass, which was precisely measured by CT, independently affected lung function proportionally after adjusting for confounding factors in relatively healthy adults.

scholarly journals The Association between Nonalcoholic Fatty Liver Disease and CT-Measured Skeletal Muscle Mass

2018 ◽  
Vol 7 (10) ◽  
pp. 310 ◽  
Author(s):  
Eun Choe ◽  
Hae Kang ◽  
Boram Park ◽  
Jong Yang ◽  
Joo Kim
Keyword(s):  
Skeletal Muscle ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Muscle Mass ◽  
Fatty Liver Disease ◽  
Skeletal Muscle Mass ◽  
Skeletal Muscle Index ◽  
Nonalcoholic Fatty Liver ◽  
Clinical Records

A relationship between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. The aim of this study was to evaluate the association between NAFLD and skeletal muscle mass measured by computed tomography (CT). The clinical records of individuals visiting our center for a routine health check-up who underwent abdominal ultrasonography and abdominal CT scanning were retrospectively reviewed. Sarcopenia was diagnosed according to body mass index (BMI)-adjusted skeletal muscle mass, which was measured by CT (CT-measured skeletal muscle index (SMICT)). Of the 1828 subjects (1121 males; mean age 54.9 ± 9.5 years), 487 (26.6%) were obese (BMI ≥ 25 kg/m2), and 454 (24.8%) had low muscle mass. Sarcopenic subjects had a significantly higher prevalence of NAFLD than nonsarcopenic subjects, regardless of obesity (35.9% vs. 26.8%, p = 0.004 in the nonobese group; 76.6% vs. 63.0%, p = 0.003 in the obese group). Sarcopenia was significantly associated with the risk of NAFLD (adjusted odds ratio (OR) (95% confidence interval (CI)), 1.51 (1.15–1.99)), and the risk of NAFLD increased with increasing severity of sarcopenia (adjusted OR (95% CI), 1.45 (1.09–1.92) vs. 2.51 (1.16–5.56), mild vs. severe sarcopenia, respectively). When the risk of NAFLD was analyzed according to the SMICT quartiles, the adjusted OR and 95% CI for the lowest muscle mass quartile compared to the highest were 1.78 (1.17–2.72) in males and 2.39 (1.13–5.37) in females. Low skeletal muscle mass, which was precisely measured by CT, is independently associated with NAFLD, suggesting that sarcopenia is a risk factor for NAFLD.

PS02.178: THE EFFECT OF INFLAMMATION AND NUTRITIONAL STATUS AND SARCOPENIA ON ESOPHAGEAL CANCER SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 172-172
Author(s):  
Daisuke Soma ◽  
Kazuhiko Yamada ◽  
Kyoko Nohara ◽  
Satoshi Yamashita ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Conflicts Of Interest ◽  
Prognostic Score ◽  
Lumbar Vertebrae ◽  
Glasgow Prognostic Score ◽  
Poor Prognostic Factor ◽  
Skeletal Muscle Index ◽  
Modified Glasgow Prognostic Score

Abstract Background An inflammation-based prognostic score, the modified Glasgow Prognostic Score (mGPS), has been established as a useful tool for predicting postoperative outcome in patients with cancer. Recently, depletion of skeletal muscle mass (sarcopenia) has been linked to poor outcome in several types of cancers. In this study investigated the relationship between these factors in patients with operable esopahgeal cancer. Methods Skeletal muscle mass was assessed in 87 patients who underwent esophagectomy from Jan. 2014 to Dec. 2016. The skeletal muscle tissue areas were measured by the ZioStation. The evaluated samples were slices of the third lumbar vertebrae (L3) in the inferior direction. The muscle area normalized by the square of the height (m2) is called the skeletal muscle index (SMI) (cm2/m2). The modified Glasgow prognostic score (mGPS) was measured using C-reactive protein (CRP) and albumin levels (mGPS 2: CRP > 1.0 mg/dL and albumin < 3.5 g/dL; mGPS 1: CRP > 1.0 mg/dL; mGPS 0: CRP ≤ 1.0 mg/dL). Patients were given mGPS- L group(mGPS0)or mGPS- H(mGPS1,2). Results The decrease of the skeletal muscle was higher in the mGPS2 than in the mGPS0. The rate of respiratory complications significantly higher in the sarcopenia group than in the non-sarcopenia group (P = 0.01). For other complications the differences were not significant. Kaplan-Meier analysis and log-rank test revealed that Sarcopenia and mGPS-H predicted a higher risk of mortality (P = 0.0034 and 0.0001). Univariate analyses revealed that the mGPS, Stage and Sarcopenia were associated with mortality. Multivariate analyses using these 3 factors revealed that only mGPS (HR: 3.18; 95% CI: 1.70–8.70; P = 0.02) and Sarcopenia (HR: 3.39; 95% CI: 1.27–10.6; P = 0.01) were an independent risk factor of mortality. Conclusion The mGPS was closely related on the progression of sarcopenia, and both the mGPS-H and Sarcopenia were poor prognostic factor respectively. Disclosure All authors have declared no conflicts of interest.

Clinical impact of sarcopenia on prognosis in pancreatic ductal adenocarcinoma.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 259-259
Author(s):  
Go Ninomiya ◽  
Tsutomu Fujii ◽  
Suguru Yamada ◽  
Tomonari Asano ◽  
Nao Takano ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Prognostic Factors ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
The Body ◽  
Pancreatic Ductal Carcinoma ◽  
Skeletal Muscle Index ◽  
Significant Difference

259 Background: In the past, various prognostic factors in pancreatic ductal carcinoma (PDAC) have been identified, and there found to be not only tumor-specific clinicopathological factors but also individual patient characteristics. In particular, weight loss, muscle wasting and cachexia are hallmarks of PDAC that may be associated with depletion of both skeletal muscle and adipose tissue. Most notably, sarcopenia is defined to be degenerative loss of skeletal muscle mass that is quantifiable using cross sectional imaging computed tomography (CT) by measurement of psoas area and the muscle’s density. Furthermore, visceral adipose tissue loss also has been reported to associate with a poor survival among patients with PDAC. Methods: A total of 265 patients who underwent curative surgery for PDAC were examined in this study. The total skeletal muscle and fat tissue areas were evaluated in a single image obtained at the third lumber vertebra during a preoperative computed tomography (CT) scan. The patients were assigned to either the sarcopenia or non-sarcopenia group based on their skeletal muscle index (SMI) and classified into high visceral fat area (H-VFA) or low VFA (L-VFA) groups. The association of clinicopathological features and prognosis with the body composition were statistically analyzed. Results: There were 170 patients (64.2%) with sarcopenia. The median survival time (MST) was 23.7 months for sarcopenia patients and 25.8 months for patients without sarcopenia. The MST was 24.4 months for H-VFA patients and 25.8 months for L-VFA patients. However, sarcopenia patients with BMI ≥ 22 exhibited significantly poorer survival than patients without sarcopenia (MST: 19.2 vs. 35.4 months, P = 0.025). There was a significant difference between patients with and without sarcopenia who did not receive chemotherapy (5-year survival rate: 0% vs. 68.3%, P = 0.003). The multivariate analysis revealed that tumor size, positive dissected peripancreatic tissue margin, and sarcopenia were independent prognostic factors. Conclusions: Sarcopenia is an independent prognostic factor in PDAC patients with a BMI ≥ 22. Therefore, evaluating skeletal muscle mass may be a simple and useful approach for predicting patient prognosis.

scholarly journals Characterizing Muscle Phenotype and Prognosis in Patients with Multiple Myeloma

2020 ◽  
Vol 3 ◽  
Author(s):  
Shannon Zhou ◽  
Libbie Silverman ◽  
Andrew Young ◽  
David Roodman ◽  
Attaya Suvannasankha ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Multiple Myeloma ◽  
Muscle Mass ◽  
Lumbar Vertebrae ◽  
University Hospital ◽  
Muscle Quality ◽  
Rank Test ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Skeletal Muscle Area

Background/Objective:  Low muscle mass (myopenia), poor muscle quality, myosteatosis, and muscle loss are associated with mortality in solid tumors. However, their impact in hematological malignancies remains unclear. We sought to determine how muscle phenotype relates to survival in patients with multiple myeloma.  Methods:  We performed a retrospective review of patients with multiple myeloma treated at Indiana University Hospital from 2012-2016. Total skeletal muscle area (SMA) (cm2) and radiodensity were measured on baseline (closest to diagnosis) and last CT scans at the third lumbar vertebrae area. SMA was normalized to height (SMA cm2/m2) to define skeletal muscle index (SKMI). Myopenia was defined as (SKMI) <52.4 cm2/m2 (men) and <38.5 cm2/m2 (women). Myosteatosis and obesity were defined per published BMI-specific cutoffs. Difference in survival between groups was estimated using log rank test.   Results:  Of 455 patients with multiple myeloma, 137 had more than one CT scan; 42 of these have been assessed to date. Half (21/42) were myopenic. Myopenia was equally prevalent across BMI categories and showed no association with survival. More than half of patients displayed myostetatosis; however, this was not associated with survival.  Obesity and myopenic obesity were likewise not correlated with survival. Below-median baseline SKMI correlated with mortality, HR 2.721 (95% CI, 1.160-5.564: P=0.0129). As well, below-median final SMA correlated with mortality, HR 2.381 (95% CI, 1.094-5.181, P=0.0213). On average patients lost .7129% of SMA (95% CI; -6.072%-4.646%). Females had higher mortality, HR 2.355 (95% CI 0.9895-5.604, P=0.0215).   Conclusion and Potential Impact:  Although this study represents a fraction of treated patients to date, myopenia was prevalent among patients at diagnosis of multiple myeloma. Low muscle mass and sex appear to be important prognostic factors for survival. Additional measurements as well as univariate and multivariate analyses are necessary to verify these findings and identify additional factors that contribute to survival in multiple myeloma. 

Change in skeletal muscle index and its prognostic significance in conversion therapy for initially unresectable colorectal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 56-56
Author(s):  
Hiroaki Nozawa ◽  
Shigenobu Emoto ◽  
Koji Murono ◽  
Yasutaka Shuno ◽  
Soichiro Ishihara
Keyword(s):  
Colorectal Cancer ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Skeletal Muscles ◽  
Systemic Chemotherapy ◽  
Stage Iv ◽  
The Body ◽  
Pharmacological Intervention ◽  
Conversion Therapy ◽  
Skeletal Muscle Index

56 Background: Systemic chemotherapy can cause loss of skeletal muscle mass in colorectal cancer (CRC) patients in the neoadjuvant and palliative settings. However, it is largely unknown how the body composition is changed by chemotherapy rendering unresectable CRC to resectable disease or how it affects the prognosis. This study aimed at elucidating the effects of systemic chemotherapy on skeletal muscles and survival in stage IV CRC patients who underwent conversion therapy. Methods: We reviewed 98 stage IV CRC patients who received systemic chemotherapy in our hospital. According to the treatment setting, patients were divided into the ‘Conversion’, ‘Neoadjuvant chemotherapy (NAC)’, and ‘Palliation’ groups. The cross-sectional area of skeletal muscles at the third lumbar level and changes in the skeletal muscle index (SMI), defined as the area divided by height squared, during chemotherapy were compared among patient groups. The effects of these parameters on prognosis were analyzed in the Conversion group. Results: The mean SMI increased by 8.0% during chemotherapy in the Conversion group (n = 38), whereas it decreased by 6.2% in the NAC group (n = 18) and 3.7% in the Palliation group (n = 42, p < 0.0001). Moreover, patients with increased SMI during chemotherapy had a better overall survival (OS) than those whose SMI decreased in the Conversion group (p = 0.021). The increase in SMI was an independent predictor of favorable OS on multivariate analysis (hazard ratio: 0.26). Conclusions: Stage IV CRC patients who underwent conversion to resection often had an increased SMI. As such an increase in SMI further conveys a survival benefit in conversion therapy, it may be important to make efforts to preserve muscle mass by meticulous approaches, such as nutritional support, muscle exercise programs, and pharmacological intervention even during chemotherapy in patients with metastatic CRC.

scholarly journals Skeletal muscle index and its association with mobility among community‐dwelling older women

2021 ◽  
Vol 13 (1) ◽  
pp. 37-44
Author(s):  
ZBIGNIEW M. OSSOWSKI
Keyword(s):  
Skeletal Muscle ◽  
Older People ◽  
Older Women ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Lower Extremities ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Skeletal Muscle Index ◽  
Chair Stand

Background: The loss of muscle function and reduced mobility levels are the main reasons for the limitations of independence and disability in older people. The main aim of this study was to determine the relationship between the skeletal muscle index and mobility in older women. Material and methods: ‪The study involved 166 older women. Skeletal muscle mass and other body components were determined by bioimpedance using an InBody 720 device. Functional mobility was evaluated with the timed up-and-go test. 30-second chair stand was also used to measure the level of functional strength in lower extremities. Results: ‪The skeletal muscle index was positively correlated with functional mobility (r=-0.22; p=0.00) and 30-second chair stand (r=-0.47; p=0.00). However, the strength of lower extremities was a significantly better parameter in predicting mobility in older women than the skeletal muscle index and skeletal muscle mass. Conclusions: The functional strength of lower extremity muscles and the skeletal muscle index can have a positive effect on functional mobility in older people. The results may be helpful in clinical practice when diagnosing mobility limitations and in the process of programming physical activity of older women aimed at the prevention of sarcopenia.

scholarly journals Skeletal muscle mass at C3 may not be a strong predictor for skeletal muscle mass at L3 in sarcopenic patients with head and neck cancer

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254844
Author(s):  
Joon-Kee Yoon ◽  
Jeon Yeob Jang ◽  
Young-Sil An ◽  
Su Jin Lee
Keyword(s):  
Skeletal Muscle ◽  
Head And Neck Cancer ◽  
Diagnostic Accuracy ◽  
Prediction Model ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Strong Predictor ◽  
Healthy Adults ◽  
Muscle Area ◽  
The Relationship

Purpose To evaluate the feasibility of using skeletal muscle mass (SMM) at C3 (C3 SMM) as a diagnostic marker for sarcopenia in head and neck cancer (HNC) patients. Methods We evaluated 165 HNC patients and 42 healthy adults who underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography scans. The paravertebral muscle area at C3 and skeletal muscle area at L3 were measured by CT. Pearson’s correlation was used to assess the relationship between L3 and C3 SMMs. The prediction model for L3 SMM was developed by multiple linear regression. Then the correlation and the agreement between actual and predicted L3 SMMs were assessed. To evaluate the diagnostic value of C3 SMM for sarcopenia, the receiver operating characteristics (ROC) curves were analyzed. Results Of the 165 HNC patients, 61 (37.0%) were sarcopenic and 104 (63.0%) were non-sarcopenic. A very strong correlation was found between L3 SMM and C3 SMM in both healthy adults (r = 0.864) and non-sarcopenic patients (r = 0.876), while a fair association was found in sarcopenic patients (r = 0.381). Prediction model showed a very strong correlation between actual SMM and predicted L3 SMM in both non-sarcopenic patients and healthy adults (r > 0.9), whereas the relationship was moderate in sarcopenic patients (r = 0.7633). The agreement between two measurements was good for healthy subjects and non-sarcopenic patients, while it was poor for sarcopenic patients. On ROC analysis, predicted L3 SMM showed poor diagnostic accuracy for sarcopenia. Conclusions A correlation between L3 and C3 SMMs was weak in sarcopenic patients. A prediction model also showed a poor diagnostic accuracy. Therefore, C3 SMM may not be a strong predictor for L3 SMM in sarcopenic patients with HNC.

scholarly journals Simplified morphological evaluation of skeletal muscle mass and maximum muscle strength in healthy young women: Comparison between thigh and calf

2020 ◽  
Vol 16 ◽  
pp. 174550652096200
Author(s):  
Tomohiro Yasuda
Keyword(s):  
Skeletal Muscle ◽  
Regression Analysis ◽  
Muscle Mass ◽  
Young Women ◽  
Skeletal Muscle Mass ◽  
Handgrip Strength ◽  
Muscle Thickness ◽  
Skeletal Muscle Index ◽  
Stand Test ◽  
Sit To Stand

Objectives: The purpose of this study was to examine the prediction of skeletal muscle mass and maximum muscle strength using simplified morphology evaluation in young Japanese women from the thigh and calf perspective. Methods: A total of 249 Japanese young women (aged 18–25 years) were used for data analyses in this study. Thigh and calf girths were measured using a tape measure at 50% of thigh length and at 30% proximal of calf length, respectively. Muscle thickness was measured using B-mode ultrasound at the anterior and posterior thigh (at 50% of thigh length) and at the posterior lower leg (at 30% proximal of calf length), respectively. The measurements were carried out on the right side of the body while the participants stood with their elbows extended and relaxed. A stepwise multiple regression analysis (method of increasing and decreasing the variables; criterion set at p < 0.05) was performed for skeletal muscle index (defined by appendicular skeletal muscle mass/height2), handgrip strength, or sit-to-stand test and five variable factors (girth (thigh and calf) and muscle thickness (anterior and posterior thigh and posterior calf)). Results: Unlike the sit-to-stand test, skeletal muscle index or handgrip strength was correlated ( p < 0.001) with the girth or muscle thickness for both thigh and calf. Unlike the sit-to-stand test, the prediction equations for skeletal muscle index and handgrip strength estimation showed significant correlations with multiple regression analysis of data obtained from the calf girth and muscle thickness. In both skeletal muscle index and handgrip strength, calf girth was adopted as a Step 1, respectively. Conclusion: Our results indicated that skeletal muscle index and handgrip strength could be evaluated by the simplified morphology methods, especially that for the calf girth measurement, which may be a good indicator of screening/preventing for sarcopenia in healthy Japanese young women.

scholarly journals The Association between Serum Uric Acid and Appendicular Skeletal Muscle Mass and the Effect of Their Interaction on Mortality in Patients on Peritoneal Dialysis

2020 ◽  
Vol 45 (6) ◽  
pp. 969-981
Author(s):  
Xi Xiao ◽  
Chunyan Yi ◽  
Yuan Peng ◽  
Hongjian Ye ◽  
Haishan Wu ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Uric Acid ◽  
Peritoneal Dialysis ◽  
Serum Uric Acid ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
The Body ◽  
All Cause Mortality ◽  
Appendicular Skeletal Muscle ◽  
Appendicular Skeletal Muscle Mass

<b><i>Background:</i></b> Serum uric acid (SUA) has been revealed to be positively associated with the body composition parameters in hemodialysis patients, but few studies have investigated that in patients on peritoneal dialysis (PD). The aim of this study was to identify the relationship between SUA and appendicular skeletal muscle mass (ASM) and the effect of their interaction on mortality in PD patients. <b><i>Methods:</i></b> This was a single-center retrospective cohort study. Patients who underwent multifrequency bioelectrical impedance analysis between January 1, 2013, and December 31, 2016, and had data on SUA values were enrolled. All patients were followed up until December 31, 2019. <b><i>Results:</i></b> In total, 802 prevalent PD patients (57.9% male), with mean age of 46.2 ± 14.2 years were enrolled. The average SUA and ASM were 6.8 ± 1.3 mg/dL and 21.2 ± 4.9 kg. According to multiple linear regression models, SUA was positively associated with relative ASM in middle-aged and older PD patients (standardized coefficients [β] 0.117; 95% confidence interval [CI] 0.027, 0.200; <i>p</i> = 0.010). Further sex-stratified analysis showed that the association existed only in males (β 0.161; 95% CI 0.017, 0.227; <i>p</i> = 0.023). Moreover, the presence of hyperuricemia was found to predict lower risk of all-cause mortality (hazard ratio [HR] 0.514, 95% CI 0.272, 0.970; <i>p</i> = 0.040) only in patients with lower relative ASM. And, the adjusted HR of every 1 mg/dL elevated SUA level was 0.770 (95% CI 0.609, 0.972; <i>p</i> = 0.028) for all-cause mortality in the lower relative ASM subgroup. <b><i>Conclusions:</i></b> There exists a positive association between the SUA and ASM, and the ASM significantly affected the association between SUA and all-cause PD mortality.

Sarcopenia and altered body composition following abiraterone acetate (AA) and corticosteroid (C) treatment in men with castration-refractory prostate cancer (CRPC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15134-e15134
Author(s):  
Deborah Mukherji ◽  
Carmel Jo Pezaro ◽  
Diletta Bianchini ◽  
Nina Tunariu ◽  
Amy Mulick Cassidy ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Median Duration ◽  
Visceral Fat ◽  
Muscle Area ◽  
Skeletal Muscle Index ◽  
Advanced Malignancy ◽  
Total Fat

e15134 Background: Sarcopenia, or skeletal muscle wasting, is an independent prognostic factor in advanced malignancy (Prado Lancet Onc 2008). Decreased muscle and increased fat are recognized side effects of androgen deprivation therapy. AA is a CYP17 inhibitor administered with corticosteroids (C), approved for treatment of advanced CRPC. AA reduces circulating androgens to ‘super-castrate’ levels; we hypothesized that AA + C would impact body composition. Methods: We retrospectively evaluated 54 CRPC pts treated on a Phase I/II trial. Pts received AA alone followed by combination AA + C on biochemical progression. CT scans at baseline, on AA alone and on AA + C were analyzed. Cross-sectional areas of fat and muscle were measured on 3 consecutive images at L4 using OsiriX 4.0. Muscle area was used to calculate skeletal muscle index (SMI); sarcopenia was defined as SMI <52.4 cm2/m2. Data were analyzed using t-tests and Kaplan-Meier analysis with overall survival (OS) measured from day 1 of AA. Results: Median duration on AA alone was 7.4 months (m; range 1.4-37.5); median duration on concurrent AA + C was 7.4m (range 0.9-46.2). Body composition did not change between two pre-treatment scans (n=29; median 3m apart). On AA alone there was a decrease in total fat (-8.5%, p=0.0001), visceral fat (-9.8%, p=0.0015) and muscle mass (-3.9%, p=0.0023) with a significant decrease in mean body mass index (BMI; -3.4 %, p=0.0118). Conversely AA + C was associated with increased total fat (+15.1%, p<0.0001) and visceral fat (+21.4%, p<0.0001) but no further change in muscle mass. Mean BMI significantly increased on the addition of C, returning to baseline levels (p< 0.0001). Overall, 13 pts (24%) were sarcopenic prior to commencing AA compared to 22 (41%) at the end of treatment. Pts who were sarcopenic at baseline had significantly reduced OS: 26.1m (95%CI 16.6 – 41) vs 46.5m (95%CI 28.6 – 57.5, p=0.0253). Conclusions: Treatment with AA alone resulted in decreased fat and muscle. AA + C increased body fat without further alteration in muscle mass. Changes in BMI did not reflect changes in body composition. Sarcopenia at baseline was a negative prognostic factor in this population.

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