Dual Use of Skeletal Muscle Index and Body Mass Index Measured at the Time of Diagnosis Predicts Prognosis in Children With Malignant Solid Tumors: A Single-Center Retrospective Study.

IF 2.3 3区 医学 Q2 HEMATOLOGY
Wataru Kudo, Keita Terui, Katsuhiro Nishimura, Daisuke Katsumi, Ryoya Furugane, Ayako Takenouchi, Shugo Komatsu, Satoru Oita, Yunosuke Kawaguchi, Tomoro Hishiki
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引用次数: 0

Abstract

Background: Sarcopenia, a progressive muscle-wasting disorder, is increasingly being recognized in childhood cancers. While skeletal muscle index (SMI) is commonly used to assess sarcopenia, we investigated the combined utility of SMI and body mass index (BMI) in predicting the prognosis of children with malignant solid tumors.

Methods: The BMI and SMI of 119 children with different types of malignant solid tumors were analyzed. Computed tomography and height at the time of diagnosis were used to determine the SMI. SMI and BMI were standardized using reference values. Cluster and survival time analyses were conducted to identify subpopulations.

Results: Cluster analysis performed using z-scores for SMI and BMI yielded four clusters: Cluster 1 had high z-scores for both indices; Cluster 2 had average z-scores for both indices; Cluster 3 had low z-scores for SMI and average z-scores for BMI; and Cluster 4 had low z-scores for both indices. Cluster classification was an independent prognostic factor for both event-free survival (hazard ratio 1.56; 95% confidence interval: 1.09-2.25) and overall survival (hazard ratio 1.70; 95% confidence interval: 1.10-2.64) after combining age and metastasis. Cluster 1 had low metastasis prevalence and a favorable prognosis, whereas Cluster 4 exhibited a poorer prognosis.

Conclusion: The potential prognoses of the four distinct patient clusters based on the z-scores for SMI and BMI at the time of diagnosis were determined. The dual use of SMI and BMI may facilitate the identification of children with malignant solid tumors who are at a high risk of poor outcomes.

诊断时测量骨骼肌指数和体重指数的双重应用预测儿童恶性实体瘤的预后:一项单中心回顾性研究
背景:肌少症是一种进行性肌肉萎缩疾病,越来越多地在儿童癌症中得到认可。虽然骨骼肌指数(SMI)通常用于评估肌肉减少症,但我们研究了SMI和体重指数(BMI)在预测恶性实体瘤儿童预后中的联合应用。方法:对119例不同类型恶性实体瘤患儿的BMI和SMI进行分析。使用计算机断层扫描和诊断时的身高来确定SMI。采用参考值对SMI和BMI进行标准化。通过聚类和生存时间分析来确定亚种群。结果:使用SMI和BMI的z分数进行聚类分析得出四个聚类:聚类1的两个指数的z分数都很高;聚类2具有两个指标的平均z分数;聚类3的SMI z-score较低,BMI z-score平均;聚类4两项指标的z-得分均较低。在结合年龄和转移后,聚类分类是无事件生存(风险比1.56,95%可信区间1.09-2.25)和总生存(风险比1.70,95%可信区间1.10-2.64)的独立预后因素。集群1转移率低,预后良好,而集群4预后较差。结论:基于诊断时SMI和BMI的z分数,确定了四种不同患者群的潜在预后。SMI和BMI的双重使用可能有助于识别预后不良的高危恶性实体瘤儿童。
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来源期刊
Pediatric Blood & Cancer
Pediatric Blood & Cancer 医学-小儿科
CiteScore
4.90
自引率
9.40%
发文量
546
审稿时长
1.5 months
期刊介绍: Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.
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