Journal
TARGETED ONCOLOGY
Volume 11, Issue 5, Pages 605-617Publisher
SPRINGER
DOI: 10.1007/s11523-016-0430-0
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Cancer cachexia is associated with patient outcomes. The objective was to evaluate the effect of cachexia on survival among patients with metastatic renal cell carcinoma (mRCC) who had received first-line sunitinib treatment. Seventy-one patients were retrospectively evaluated. Sarcopenia was diagnosed using sex-specific cut-offs for skeletal muscle index (measured using pre-treatment computed tomography) that were adjusted for body mass index. The modified Glasgow prognostic score (mGPS) was measured using C-reactive protein (CRP) and albumin levels (mGPS 2: CRP > 1.0 mg/dL and albumin < 3.5 g/dL; mGPS 1: CRP > 1.0 mg/dL; mGPS 0: CRP aecurrency sign1.0 mg/dL). Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox proportional hazard models. Forty-five patients (63.4 %) had sarcopenia, with 53 (74.6 %), ten (14.1 %), and eight (11.3 %) patients having an mGPS of 0, 1, and 2, respectively. Sarcopenia was associated with significantly inferior PFS and OS, compared to non-sarcopenic patients (PFS: 7.6 vs. 18.2 months, p = 0.0004; OS: 22.3 months vs. not reached, p = 0.0019). Higher mGPS was associated with inferior PFS and OS (mGPS 0, 1, and 2: PFS = 11.5, 10.9, and 4.12 months, p < 0.0001; OS = 47.2, not reached, and 5.28 months, p < 0.0001; respectively). Sarcopenia was an independent predictor of shorter PFS (p = 0.0163), and mGPS was an independent predictor of shorter OS (p = 0.0012). Sarcopenia and mGPS can predict outcomes among patients with mRCC who are receiving first-line sunitinib treatment.
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