Korean J Radiol.  2022 Feb;23(2):159-171. 10.3348/kjr.2020.1475.

Impact of Skeletal Muscle Loss and Visceral Obesity Measured Using Serial CT on the Prognosis of Operable Breast Cancers in Asian Patients

• Kwon Mr
• Ko ES
• Park MS
• Jeong WK
• Hwang NY
• Kim JH
• Lee JE
• Kim SW
• Yu JH
• Han BK
• Ko EY
• Choi JS
• Park KW

• KMID: 2525213
• DOI: http://doi.org/10.3348/kjr.2020.1475

Abstract

Objective
This study aimed to investigate the impact of baseline values and temporal changes in body composition parameters, including skeletal muscle index (SMI) and visceral adipose tissue area (VAT), measured using serial computed tomography (CT) imaging on the prognosis of operable breast cancers in Asian patients.
Materials and Methods
This study retrospectively included 627 Asian female (mean age ± standard deviation [SD], 53.6 ± 8.3 years) who underwent surgery for stage I–III breast cancer between January 2011 and September 2012. Body composition parameters, including SMI and VAT, were semi-automatically calculated on baseline abdominal CT at the time of diagnosis and follow-up CT for post-treatment surveillance. Serial changes in SMI and VAT were calculated as the delta values. Multivariable Cox regression analysis was used to evaluate the association of baseline and delta SMI and VAT values with disease-free survival.
Results
Among 627 patients, 56 patients (9.2%) had breast cancer recurrence after a median of 40.5 months. The mean value ± SD of the baseline SMI and baseline VAT were 43.7 ± 5.8 cm² /m² and 72.0 ± 46.0 cm² , respectively. The mean value of the delta SMI was -0.9 cm² /m² and the delta VAT was 0.5 cm² . The baseline SMI and VAT were not significantly associated with disease-free survival (adjusted hazard ratio [HR], 0.983; 95% confidence interval [CI], 0.937–1.031; p = 0.475 and adjusted HR, 1.001; 95% CI, 0.995–1.006; p = 0.751, respectively). The delta SMI and VAT were also not significantly associated with disease-free survival (adjusted HR, 0.894; 95% CI, 0.766–1.043; p = 0.155 and adjusted HR, 1.001; 95% CI, 0.989–1.014; p = 0.848, respectively).
Conclusion
Our study revealed that baseline and early temporal changes in SMI and VAT were not independent prognostic factors regarding disease-free survival in Asian patients undergoing surgery for breast cancer.

Keyword

Skeletal muscle index; Visceral adipose tissue area; Computed tomography; Disease-free survival; Recurrence; Breast cancer