PMID- 31232439
OWN - NLM
STAT- MEDLINE
DCOM- 20201118
LR  - 20201118
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 86
IP  - 5
DP  - 2020 May 1
TI  - Sarcopenia Predicts Overall Survival in Patients with Lung, Breast, Prostate, or 
      Myeloma Spine Metastases Undergoing Stereotactic Body Radiation Therapy (SBRT), 
      Independent of Histology.
PG  - 705-716
LID - 10.1093/neuros/nyz216 [doi]
AB  - BACKGROUND: Predicting survival of patients with spinal metastases would help 
      stratify treatments from aggressive to palliation. OBJECTIVE: To evaluate whether 
      sarcopenia predicts survival in patients with lung, breast, prostate, or multiple 
      myeloma spinal metastases. METHODS: Psoas muscle measurements in patients with 
      spinal metastasis were taken from computed tomography scans at 2 time points: at 
      first episode of stereotactic body radiation therapy (SBRT) and from the most 
      recent scan available. Overall survival and hazard ratios were calculated with 
      multivariate cox proportional hazards regression analyses. RESULTS: In 417 
      patients with spinal metastases, 40% had lung cancer, 27% breast, 21% prostate, 
      and 11% myeloma. Overall survival was not associated with age, sex, ethnicity, 
      levels treated, or SBRT volume. Multivariate analysis showed patients in the 
      lowest psoas tertile had shorter survival (222 d, 95% CI = 185-323 d) as compared 
      to the largest tertile (579 d, 95% CI = 405-815 d), (HR1.54, P = .005). Median 
      psoas size as a cutoff value was also strongly predictive for survival (HR1.48, 
      P = .002). Survival was independent of tumor histology. The psoas/vertebral body 
      ratio was also successful in predicting overall survival independent of tumor 
      histology and gender (HR1.52, P < .01). Kaplan-Meier survival curves visually 
      represent survival (P = .0005). CONCLUSION: In patients with spine metastases, 
      psoas muscle size as a hallmark of frailty/sarcopenia is an objective, simple, 
      and effective way to identify patients who are at risk for shorter survival, 
      regardless of tumor histology. This information can be used to help with surgical 
      decision making in patients with advanced cancer, as patients with small psoas 
      sizes are at higher risk of death.
CI  - Copyright (c) 2019 by the Congress of Neurological Surgeons.
FAU - Zakaria, Hesham Mostafa
AU  - Zakaria HM
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Llaniguez, Jeremy T
AU  - Llaniguez JT
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Telemi, Edvin
AU  - Telemi E
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Chuang, Matthew
AU  - Chuang M
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Abouelleil, Mohamed
AU  - Abouelleil M
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Wilkinson, Brandon
AU  - Wilkinson B
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Chandra, Ankush
AU  - Chandra A
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Boyce-Fappiano, David
AU  - Boyce-Fappiano D
AD  - Department of Public Health Sciences, Neuroscience Institute, Henry Ford 
      Hospital, Detroit, Michigan.
FAU - Elibe, Erinma
AU  - Elibe E
AD  - Department of Public Health Sciences, Neuroscience Institute, Henry Ford 
      Hospital, Detroit, Michigan.
FAU - Schultz, Lonni
AU  - Schultz L
AD  - Department of Radiology, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Siddiqui, Farzan
AU  - Siddiqui F
AD  - Department of Public Health Sciences, Neuroscience Institute, Henry Ford 
      Hospital, Detroit, Michigan.
FAU - Griffith, Brent
AU  - Griffith B
AD  - Department of Radiation Oncology, Neuroscience Institute, Henry Ford Hospital, 
      Detroit, Michigan.
FAU - Kalkanis, Steven N
AU  - Kalkanis SN
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Lee, Ian Yu
AU  - Lee IY
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
FAU - Chang, Victor
AU  - Chang V
AD  - Department of Neurosurgery, Neuroscience Institute, Henry Ford Hospital, Detroit, 
      Michigan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Breast Neoplasms/complications/pathology
MH  - Female
MH  - *Frailty/etiology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Lung Neoplasms/complications/pathology
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/complications/pathology
MH  - Multivariate Analysis
MH  - Proportional Hazards Models
MH  - Prostatic Neoplasms/complications/pathology
MH  - Psoas Muscles/pathology
MH  - Radiosurgery/methods
MH  - Retrospective Studies
MH  - *Sarcopenia/etiology/pathology
MH  - Spinal Neoplasms/*mortality/*secondary
OTO - NOTNLM
OT  - Frailty
OT  - Medical oncology
OT  - Metastasis
OT  - Sarcopenia
OT  - Spine
EDAT- 2019/06/25 06:00
MHDA- 2020/11/20 06:00
CRDT- 2019/06/25 06:00
PHST- 2018/10/18 00:00 [received]
PHST- 2019/03/11 00:00 [accepted]
PHST- 2019/06/25 06:00 [pubmed]
PHST- 2020/11/20 06:00 [medline]
PHST- 2019/06/25 06:00 [entrez]
AID - 5522288 [pii]
AID - 10.1093/neuros/nyz216 [doi]
PST - ppublish
SO  - Neurosurgery. 2020 May 1;86(5):705-716. doi: 10.1093/neuros/nyz216.