Abstract
Purpose
Temporal muscle thickness (TMT) has been suggested as a novel biomarker that can represent sarcopenia in head and neck malignancies. This study investigated the association of TMT with clinical outcomes in patients with newly diagnosed glioblastoma (GBM).
Methods
Using electronic medical records, all GBM patients between 2008 and 2018 at Seoul St. Mary’s Hospital were reviewed. Total 177 patients met our eligibility criteria.
Results
The thinner group who had TMT less than the median showed shorter overall survival (OS) and progression-free survival (PFS) than the thicker group who had TMT more than median (OS; 11.0 versus 18.0 months, p < 0.001, and PFS; 6.0 versus 11.0 months, p < 0.001). In the multivariate analysis, the thinner group had negative associations with OS and PFS (OS; HR 2.63 (1.34–2.63), p < 0.001, and PFS; HR 2.21 (1.34–2.50), p = 0.002). We also performed propensity score matching between the thinner and thicker groups to minimize the potential bias. The thinner group showed shorter OS and PFS (OS; 13.5 versus 19.0 months, p = 0.006, and PFS; 6.5 versus 9.0 months, p = 0.028) and had negative associations with OS and PFS than the thicker group (OS; HR 1.90 (1.19–3.03), p = 0.008, and PFS; HR 1.70 (1.07–2.70), p = 0.026) in matched patients.
Conclusion
Our findings suggest that TMT can be a useful prognostic biomarker for clinical outcomes in GBM patients. Further preclinical and clinical studies could help elucidate this association of sarcopenia with clinical outcomes in GBM patients.




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Data availability
All data supporting the findings presented in this manuscript are available upon reasonable request directly to the corresponding author.
References
Argilés JM, Busquets S, López-Soriano FJ, Costelli P, Penna F (2012) Are there any benefits of exercise training in cancer cachexia?. Springer, Berlin
Argiles JM, Busquets S, Stemmler B, Lopez-Soriano FJ (2015) Cachexia and sarcopenia: mechanisms and potential targets for intervention. Curr Opin Pharmacol 22:100–106
Austin PC (2009) Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Stat Med 28:3083–3107
Benadon B et al. (2020) Sarcopenia: an important prognostic factor for males treated for a locally advanced esophageal carcinoma. Digest Liver Dis
Braun K, Ahluwalia MS (2017) Treatment of glioblastoma in older adults. Curr Oncol Rep 19:81
Brown TJ et al (2016) Association of the extent of resection with survival in glioblastoma: a systematic review and meta-analysis. JAMA Oncol 2:1460–1469
Caan BJ et al (2018) Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol 4:798–804
Chargi N, Bril S, Emmelot-Vonk M, de Bree R (2019) Sarcopenia is a prognostic factor for overall survival in elderly patients with head-and-neck cancer. Eur Arch Otorhinol 276:1475–1486
Cruz-Jentoft AJ et al (2010) Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in Older PeopleA J Cruz-Gentoft et al. Age Ageing 39:412–423
Dallmann R et al (2011) The orally active melanocortin-4 receptor antagonist BL-6020/979: a promising candidate for the treatment of cancer cachexia. J Cachexia Sarcopenia Muscle 2:163
Dunne RF, Loh KP, Williams GR, Jatoi A, Mustian KM, Mohile SG (2019) Cachexia and sarcopenia in older adults with cancer: a comprehensive review. Cancers 11:1861
Dupont J, Dedeyne L, Dalle S, Koppo K, Gielen E (2019) The role of omega-3 in the prevention and treatment of sarcopenia. Aging Clin Exp Res 31:825–836
Fearon K et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12:489–495
Fukushima H, Takemura K, Suzuki H, Koga F (2018) Impact of sarcopenia as a prognostic biomarker of bladder cancer. Int J Mol Sci 19:2999
Furtner J et al (2017) Survival prediction using temporal muscle thickness measurements on cranial magnetic resonance images in patients with newly diagnosed brain metastases. Eur Radiol 27:3167–3173
Furtner J et al (2018) Temporal muscle thickness is an independent prognostic marker in melanoma patients with newly diagnosed brain metastases. J Neurooncol 140:173–178
Furtner J et al (2019) Temporal muscle thickness is an independent prognostic marker in patients with progressive glioblastoma: translational imaging analysis of the EORTC 26101 trial. Neuro-oncology 21:1587–1594
Ganju RG, Morse R, Hoover A, TenNapel M, Lominska CE (2019) The impact of sarcopenia on tolerance of radiation and outcome in patients with head and neck cancer receiving chemoradiation. Radiother Oncol 137:117–124
Kawamura T et al (2018) Long-term outcomes of gastric cancer patients with preoperative sarcopenia. Ann Surg Oncol 25:1625–1632
Kilgour AH, Subedi D, Gray CD, Deary IJ, Lawrie SM, Wardlaw JM, Starr JM (2012) Design and validation of a novel method to measure cross-sectional area of neck muscles included during routine MR brain volume imaging. PLoS ONE 7:e34444
Kung T, Springer J, Doehner W, Anker SD, Von Haehling S (2010) Novel treatment approaches to cachexia and sarcopenia: highlights from the 5th Cachexia Conference: Barcelona, Spain, 5–8 December 2009. Expert Opin Investig Drugs 19:579–585
Leitner J et al (2018) High correlation of temporal muscle thickness with lumbar skeletal muscle cross-sectional area in patients with brain metastases. PLoS ONE 13:e0207849
Looijaard SM, te Lintel Hekkert ML, Wüst RC, Otten RH, Meskers CG, Maier AB (2020) Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass. Acta Physiol e13516
Olson B et al. (2020) Association of sarcopenia with oncologic outcomes of primary surgery or definitive radiotherapy among patients with localized oropharyngeal squamous cell carcinoma. JAMA Otolaryngol–Head Neck Surgery
Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, Barnholtz-Sloan JS (2019) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2012–2016. Neuro-Oncology 21:v1–v100
Padhi D, Higano CS, Shore ND, Sieber P, Rasmussen E, Smith MR (2014) Pharmacological inhibition of myostatin and changes in lean body mass and lower extremity muscle size in patients receiving androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab 99:E1967–E1975
Prado CM et al (2007) Body composition as an independent determinant of 5-fluorouracil–based chemotherapy toxicity. Clin Cancer Res 13:3264–3268
Prado CM et al (2009) Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res 15:2920–2926
Ranganathan K et al (2014) Temporalis muscle morphomics: the psoas of the craniofacial skeleton. J Surg Res 186:246–252
Sanai N, Polley M-Y, McDermott MW, Parsa AT, Berger MS (2011) An extent of resection threshold for newly diagnosed glioblastomas. J Neurosurg 115:3–8
Shachar SS, Williams GR, Muss HB, Nishijima TF (2016) Prognostic value of sarcopenia in adults with solid tumours: a meta-analysis and systematic review. Eur J Cancer 57:58–67
Stupp R et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996
Stupp R et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10:459–466
Swartz JE et al (2016) Feasibility of using head and neck CT imaging to assess skeletal muscle mass in head and neck cancer patients. Oral Oncol 62:28–33
Yang M, Shen Y, Tan L, Li W (2019) Prognostic value of sarcopenia in lung cancer: a systematic review and meta-analysis. Chest 156:101–111
Funding
This research was supported by the Bio and Medical Technology Development Program of the National Research Foundation funded by the Ministry of Science and ICT at South Korea (NRF- 2020M3A9E8024875).
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Conceptualization: SA. Methodology, data curation: GA, SA. Writing—original draft preparation: GA, SA. Writing—review and editing: J-SP, S-SJ, Y-KH. Funding acquisition: SA.
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The authors declare no conflicts of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.
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This study has been approved by the Institutional Review Board of Seoul St. Mary’s Hospital.
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An, G., Ahn, S., Park, JS. et al. Association between temporal muscle thickness and clinical outcomes in patients with newly diagnosed glioblastoma. J Cancer Res Clin Oncol 147, 901–909 (2021). https://doi.org/10.1007/s00432-020-03386-5
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DOI: https://doi.org/10.1007/s00432-020-03386-5