Opportunistic muscle measurements on staging chest CT for extremity and truncal soft tissue sarcoma are associated with survival.
BACKGROUND AND OBJECTIVES
Computed tomography (CT) measurements of sarcopenia have been proposed as biomarkers associated with outcomes in various cancers and have typically been evaluated at the L3 vertebral level. However, staging imaging for patients with extremity and truncal soft tissue sarcoma (STS) often only includes chest CT imaging which precludes evaluation at L3. Therefore, we sought to evaluate muscle metrics at T12 on standard staging chest CT scans and evaluate for correlation with overall and event-free survival in patients with STS.


METHODS
CT chest imaging for 89 patients with intermediate and high-grade STS (53 male, 36 female; 58.5 ± 19.0 years old, follow-up 37.4 ± 27.1 months) was reviewed on PACS at T12 for skeletal muscle density (SMD) and skeletal muscle index (SMI).


RESULTS
Overall survival increased with increased SMD on univariate (hazard ratio [HR] = 0.61 [0.43, 0.86]) and age-adjusted analysis (HR = 0.65 [0.42, 0.89]. Event-free survival also increased with increased SMD in univariate analyses (HR = 0.68 [0.49, 0.95]) but did not maintain significance after adjusting for age (HR = 0.68 [0.43, 1.07]). SMI was not a predictor of overall or event-free survival.


CONCLUSIONS
Higher SMD measured on routinely obtained staging chest CTs in STS patients is associated with improved survival.
['Phan|Eileen N|EN|http://orcid.org/0000-0002-3770-2626', 'Thorpe|Steven W|SW|https://orcid.org/0000-0003-3127-4912', 'Wong|Felix S|FS|', 'Saiz|Augustine M|AM|http://orcid.org/0000-0002-1955-8667', 'Taylor|Sandra L|SL|', 'Canter|Robert J|RJ|http://orcid.org/0000-0002-3331-5418', 'Lenchik|Leon|L|', 'Randall|R Lor|RL|', 'Boutin|Robert D|RD|https://orcid.org/0000-0001-7887-9658']
D018572:Disease-Free Survival D005121:Extremities D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D018482:Muscle, Skeletal D009367:Neoplasm Staging D012189:Retrospective Studies D012509:Sarcoma D055948:Sarcopenia D015996:Survival Rate D014057:Tomography, X-Ray Computed D060726:Torso
sarcoma sarcopenia muscle metrics myosteatosis