(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer

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Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

L5HU and psoas L4–L5, surrogates for bone mineral density and muscle mass, respectively, were independent predictors of overall survival in a multivariable model controlling for age, comorbidity, prostate cancer risk grouping, race, and ADT.

Andrew M. McDonald, MD, Thomas A. Swain, BS, David L. Mayhew, MD, PhD, Rex A. Cardan, Christopher B. Bakder, BS, David M. Harris, BS, John B. Fiveash; University of Alabama at Birmingham; Tufts University

BACKGROUND: Death in men with localized prostate cancer tends to be due to competing risks, and measures of health, such as the Charlson Comorbidity Index (CCI), have been validated as predictors of survival. We investigated if CT-assessed metrics of bone mineral density (BMD) and muscle mass yielded additional prognostic information.

MATERIALS AND METHODS: Demographic, disease, and treatment characteristics were abstracted from each patient’s chart, and age-adjusted CCI at the time of treatment was calculated. On a single axial CT slice at the mid-L5 level, the average CT attenuation of the trabecular bone of the vertebral body (L5HU) was measured using a custom script within Varian Eclipse software. The cross-sectional area of the bilateral psoas muscles (psoas L4–L5) was measured on a single CT slice at the L4–L5 vertebral interface. Cox proportional hazards models were used to assess the effects on overall survival. Using the parameter estimates from an adjusted multivariable model, a new prognostic index was generated and compared with age-adjusted CCI using Harrell’s c-index.

RESULTS: Clinical data and CT scans were available for 652 patients. Prostate cancer risk grouping, use of androgen deprivation therapy (ADT), race, age-adjusted CCI, L5HU, and psoas L4–L5 were included in a multivariable model. Increased age-adjusted CCI (hazard ratio [HR], 1.3 [95% CI, 1.19–1.43]), L5HU (HR, 2.38 [95% CI, 1.43–3.97 for L5HU < 105]; HR, 1.23 [95% CI, 0.83–1.81 for 105 ≤ L5HU ≤ 150]), and psoas L4–L5 (HR, 2.01 [95% CI, 1.38–2.94 for psoas L4–L5 < 7.5 cm2/m2]) were independent predictors of the hazard of death. The new prognostic index generated from these three variables yielded c = 0.73 vs c = 0.69 for age-adjusted CCI alone.

CONCLUSION: L5HU and psoas L4–L5, surrogates for BMD and muscle mass, respectively, were independent predictors of overall survival in a multivariable model controlling for age, comorbidity, prostate cancer risk grouping, race, and ADT. The new prognostic index was associated with improved accuracy for predicting death and may be useful for patient stratification in future randomized trials.

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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