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Annals of Surgical Oncology Feb 2023To examine sex-specific differences in renal cell carcinoma (RCC) in relation to abdominal fat accumulation, psoas muscle density, tumor size, pathology, and survival,...
PURPOSE
To examine sex-specific differences in renal cell carcinoma (RCC) in relation to abdominal fat accumulation, psoas muscle density, tumor size, pathology, and survival, and to evaluate possible associations with RCC characteristics and outcome.
METHODS
A total of 470 patients with RCC who underwent nephrectomy between 2006 and 2019 were included in this retrospective study. Specific characteristics of RCC patients were collected, including sex, height, tumor size, grade, and data on patient survival, if available. Abdominal fat measurements and psoas muscle area were determined at the level of L3 (cm).
RESULTS
Women had a higher subcutaneous (p < 0.001) and men had a higher visceral fat area, relative proportion of visceral fat area (p < 0.001), and psoas muscle index (p < 0.001). Logistic regression analysis showed an association between higher psoas muscle index and lower grade tumors [women: odds ratio (OR) 0.94, 95% confidence interval (CI) 0.89-0.99, p = 0.011; men: OR 0.97 (95% CI, 0.95-0.99, p = 0.012]. Univariate regression analysis demonstrated an association between psoas muscle index and overall survival (women: OR 1.41, 95% CI 1.03-1.93, p = 0.033; men: OR 1.62 (95% CI, 1.33-1.97, p < 0.001). In contrast, there were no associations between abdominal fat measurements and tumor size, grade, or survival. Also, there were no sex-specific differences in tumor size or tumor grades.
CONCLUSIONS
A higher preoperative psoas muscle index was independently associated with overall survival in RCC patients, with a stronger association in men compared with women. In addition, the psoas muscle index showed an inverse association with tumor grade, whereby this association was slightly more pronounced in women than in men.
Topics: Humans; Male; Female; Carcinoma, Renal Cell; Retrospective Studies; Sex Characteristics; Body Composition; Psoas Muscles; Kidney Neoplasms
PubMed: 36352298
DOI: 10.1245/s10434-022-12738-z -
Journal of Vascular Surgery Nov 2021Statin therapy, associated with improved short-term survival after treatment of abdominal aortic aneurysms, may also predispose to muscle side effects. Evidence on...
OBJECTIVE
Statin therapy, associated with improved short-term survival after treatment of abdominal aortic aneurysms, may also predispose to muscle side effects. Evidence on statin-related sarcopenia is limited mainly to muscle function, and it is subject to several sources of bias. In the long term, postoperative development of sarcopenia is linked to mortality after endovascular repair (EVAR). We investigated statin use and long-term postoperative mortality after EVAR in relation to objective measurable markers of sarcopenia (psoas muscle surface area and density).
METHODS
Altogether 216 abdominal aortic aneurysm patients treated with EVAR between 2006 and 2014 at Tampere University Hospital (Finland) were retrospectively studied. Psoas muscle parameters at the L3 level were evaluated from baseline and mainly 1- to 3-year follow-up computed tomography studies. Cox regression was used to study the association between statin medication, psoas muscle changes, and all-cause mortality.
RESULTS
The majority of patients were male (87%), and the mean age was 77.7 years (standard deviation, 7.4). The median duration of follow-up was 6.3 years (interquartile range, 3.5) with a total mortality of 54.2% (n = 117). Regardless of a higher burden of comorbidities, statin users (n = 119) had lower mortality when compared with nonusers (multivariable hazard ratio [HR]: 0.69, 95% confidence interval: 0.48-0.99, P = .048). Furthermore, statin use was not associated with inferior muscle parameter values, and the relative change in psoas muscle area was actually lower in statin users compared with nonusers (-15.7% and -21.1%, P < .046).
CONCLUSIONS
Statin use is associated with lower long-term mortality among patients undergoing EVAR without predisposing to increased sarcopenia.
Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Female; Finland; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Male; Predictive Value of Tests; Psoas Muscles; Retrospective Studies; Risk Assessment; Risk Factors; Sarcopenia; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34019985
DOI: 10.1016/j.jvs.2021.04.054 -
The British Journal of Radiology Aug 2011The aim of this study was to assess the cross-sectional area (CSA) of both paraspinal and psoas muscles in patients with unilateral back pain using MRI and to correlate...
OBJECTIVES
The aim of this study was to assess the cross-sectional area (CSA) of both paraspinal and psoas muscles in patients with unilateral back pain using MRI and to correlate it with outcome measures.
METHODS
40 patients, all with informed consent, with a minimum of 3 months of unilateral back pain with or without sciatica and one-level disc disease on MRI of the lumbosacral spine were included. Patients were evaluated with self-report measures regarding pain (visual analogue score) and disability (Oswestry disability index). The CSA of multifidus, erector spinae, quadratus lumborum and psoas was measured at the disc level of pathology and the two adjacent disc levels, bilaterally. Comparison of CSAs of muscles between the affected vs symptomless side was carried out with Student's t-test and correlations were conducted with Spearman's test.
RESULTS
The maximum relative muscle atrophy (% decrease in CSA on symptomatic side) independent of the level was 13.1% for multifidus, 21.8% for erector spinae, 24.8% for quadratus lumborum and 17.1% for psoas. There was significant difference (p<0.05) between sides (symptomatic and asymptomatic) in CSA of multifidus, erector spinae, quadratus lumborum and psoas. However, no statistically significant correlation was found between the duration of symptoms (average 15.5 months), patient's pain (average VAS 5.3) or disability (average ODI 25.2) and the relative muscle atrophy.
CONCLUSION
In patients with long-standing unilateral back pain due to monosegmental degenerative disc disease, selective multifidus, erector spinae, quadratus lumborum and psoas atrophy develops on the symptomatic side. Radiologists and clinicians should evaluate spinal muscle atrophy of patients with persistent unilateral back pain.
Topics: Adult; Back Pain; Cross-Sectional Studies; Female; Humans; Intervertebral Disc Degeneration; Magnetic Resonance Imaging; Male; Middle Aged; Muscular Atrophy; Muscular Atrophy, Spinal; Pain Measurement; Psoas Muscles; Young Adult
PubMed: 21081573
DOI: 10.1259/bjr/58136533 -
Nephron 2023Computed tomography (CT) can accurately measure muscle mass, which is necessary for diagnosing sarcopenia, even in dialysis patients. However, CT-based screening for...
INTRODUCTION
Computed tomography (CT) can accurately measure muscle mass, which is necessary for diagnosing sarcopenia, even in dialysis patients. However, CT-based screening for such patients is challenging, especially considering the availability of equipment within dialysis facilities. We therefore aimed to develop a bedside prediction model for low muscle mass, defined by the psoas muscle mass index (PMI) from CT measurement.
METHODS
Hemodialysis patients (n = 619) who had undergone abdominal CT screening were divided into the development (n = 441) and validation (n = 178) groups. PMI was manually measured using abdominal CT images to diagnose low muscle mass by two independent investigators. The development group's data were used to create a logistic regression model using 42 items extracted from clinical information as predictive variables; variables were selected using the stepwise method. External validity was examined using the validation group's data, and the area under the curve (AUC), sensitivity, and specificity were calculated.
RESULTS
Of all subjects, 226 (37%) were diagnosed with low muscle mass using PMI. A predictive model for low muscle mass was calculated using ten variables: each grip strength, sex, height, dry weight, primary cause of end-stage renal disease, diastolic blood pressure at start of session, pre-dialysis potassium and albumin level, and dialysis water removal in a session. The development group's adjusted AUC, sensitivity, and specificity were 0.81, 60%, and 87%, respectively. The validation group's adjusted AUC, sensitivity, and specificity were 0.73, 64%, and 82%, respectively.
DISCUSSION/CONCLUSION
Our results facilitate skeletal muscle screening in hemodialysis patients, assisting in sarcopenia prophylaxis and intervention decisions.
Topics: Humans; Sarcopenia; Muscle, Skeletal; Psoas Muscles; Renal Dialysis; Kidney Failure, Chronic; Mass Screening; Retrospective Studies
PubMed: 36273447
DOI: 10.1159/000526866 -
European Spine Journal : Official... Jun 2013This study was undertaken to assess the change of psoas and paravertebral muscles in patients with degenerative scoliosis.
PURPOSE
This study was undertaken to assess the change of psoas and paravertebral muscles in patients with degenerative scoliosis.
METHODS
Eighty-five patients with degenerative scoliosis were evaluated with simple radiography for the location and direction of the apex of scoliosis, coronal Cobb's angle, rotational deformity and lumbar lordosis, and with magnetic resonance imaging scan at the apex level of each patient, the cross-sectional area (CSA) and the fatty infiltration rate (FI) of bilateral paravertebral and psoas muscles were measured and the values of convex and concave side were compared.
RESULTS
Fifty-three patients had apex of curves on the left side and thirty-two patients on the right. The mean Cobb's angle was 17.9°. The difference index of CSA (CDI) of psoas and multifidus muscle at apex of curvature level was significantly larger in convex side rather than that in concave side (by 6.3 and 8.4 % with P = 0.019 and 0.000, respectively). FI of each muscle showed no significant difference.
CONCLUSIONS
Hypertrophy of the muscles on the convex side is suggested as the explanation of this asymmetry rather than atrophy of the muscles on the concave side as muscle atrophy is known to be associated with increased fatty infiltration.
Topics: Aged; Aged, 80 and over; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Paraspinal Muscles; Psoas Muscles; Radiography; Scoliosis
PubMed: 23515711
DOI: 10.1007/s00586-013-2740-6 -
Journal of Cachexia, Sarcopenia and... Aug 2021Patients with Marfan syndrome are at risk for aortic enlargement and are routinely monitored by computed tomography (CT) imaging. The purpose of this study is to analyse...
BACKGROUND
Patients with Marfan syndrome are at risk for aortic enlargement and are routinely monitored by computed tomography (CT) imaging. The purpose of this study is to analyse body composition using artificial intelligence (AI)-based tissue segmentation in patients with Marfan syndrome in order to identify possible predictors of progressive aortic enlargement.
METHODS
In this study, the body composition of 25 patients aged ≤50 years with Marfan syndrome and no prior aortic repair was analysed at the third lumbar vertebra (L3) level from a retrospective dataset using an AI-based software tool (Visage Imaging). All patients underwent electrocardiography-triggered CT of the aorta twice within 2 years for suspected progression of aortic disease, suspected dissection, and/or pre-operative evaluation. Progression of aortic enlargement was defined as an increase in diameter at the aortic sinus or the ascending aorta of at least 2 mm. Patients meeting this definition were assigned to the 'progressive aortic enlargement' group (proAE group) and patients with stable diameters to the 'stable aortic enlargement' group (staAE group). Statistical analysis was performed using the Mann-Whitney U test. Two possible body composition predictors of aortic enlargement-skeletal muscle density (SMD) and psoas muscle index (PMI)-were analysed further using multivariant logistic regression analysis. Aortic enlargement was defined as the dependent variant, whereas PMI, SMD, age, sex, body mass index (BMI), beta blocker medication, and time interval between CT scans were defined as independent variants.
RESULTS
There were 13 patients in the proAE group and 12 patients in the staAE group. AI-based automated analysis of body composition at L3 revealed a significantly increased SMD measured in Hounsfield units (HUs) in patients with aortic enlargement (proAE group: 50.0 ± 8.6 HU vs. staAE group: 39.0 ± 15.0 HU; P = 0.03). PMI also trended towards higher values in the proAE group (proAE group: 6.8 ± 2.3 vs. staAE group: 5.6 ± 1.3; P = 0.19). Multivariate logistic regression revealed significant prediction of aortic enlargement for SMD (P = 0.05) and PMI (P = 0.04).
CONCLUSIONS
Artificial intelligence-based analysis of body composition at L3 in Marfan patients is feasible and easily available from CT angiography. Analysis of body composition at L3 revealed significantly higher SMD in patients with progressive aortic enlargement. PMI and SMD significantly predicted aortic enlargement in these patients. Using body composition as a predictor of progressive aortic enlargement may contribute information for risk stratification regarding follow-up intervals and the need for aortic repair.
Topics: Aorta; Artificial Intelligence; Body Composition; Humans; Marfan Syndrome; Psoas Muscles; Retrospective Studies
PubMed: 34137512
DOI: 10.1002/jcsm.12731 -
TheScientificWorldJournal 2012Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common... (Review)
Review
Spinal fusion historically has been used extensively, and, recently, the lateral transpsoas approach to the thoracic and lumbar spine has become an increasingly common method to achieve fusion. Recent literature on this approach has elucidated its advantage over more traditional anterior and posterior approaches, which include a smaller tissue dissection, potentially lower blood loss, no need for an access surgeon, and a shorter hospital stay. Indications for the procedure have now expanded to include degenerative disc disease, spinal stenosis, degenerative scoliosis, nonunion, trauma, infection, and low-grade spondylolisthesis. Lateral interbody fusion has a similar if not lower rate of complications compared to traditional anterior and posterior approaches to interbody fusion. However, lateral interbody fusion has unique complications that include transient neurologic symptoms, motor deficits, and neural injuries that range from 1 to 60% in the literature. Additional studies are required to further evaluate and monitor the short- and long-term safety, efficacy, outcomes, and complications of lateral transpsoas procedures.
Topics: Equipment Design; Humans; Prostheses and Implants; Psoas Muscles; Spinal Diseases; Spinal Fusion; Spine; Treatment Outcome
PubMed: 23213303
DOI: 10.1100/2012/893608 -
Human Vaccines & Immunotherapeutics Aug 2023Currently, the relationship between nutritional indices and the prognosis of hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors (ICIs) and...
Currently, the relationship between nutritional indices and the prognosis of hepatocellular carcinoma (HCC) patients treated with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) remains unclear. This study aims to investigate the prognostic value of psoas muscle index (PMI), prognostic nutritional index (PNI), body mass index (BMI), and geriatric nutritional risk index (GNRI) in HCC patients treated with ICIs combined with TKIs. A total of 124 male patients with HCC were included in this study. PNI, PMI, BMI, and GNRI were calculated at the beginning of treatment. The Cox proportional hazards model was used to analyze the effect of various variables. In the univariate analysis, PMI, PNI, GNRI, and ALB were found to impact the outcomes of the patients at different follow-up times. However, the predictive value of these nutritional indices was eliminated when established risk factors were considered. In the multivariate analysis that only included nutrition-related indicators, PMI emerged as an independent prognostic factor for 1-year treatment outcomes. The group with low PMI (≤5.5409 cm/m) was found to have a higher risk of death at one year and at the end of the follow-up period.
Topics: Humans; Male; Aged; Prognosis; Immune Checkpoint Inhibitors; Carcinoma, Hepatocellular; Tyrosine Kinase Inhibitors; Psoas Muscles; Liver Neoplasms
PubMed: 37728115
DOI: 10.1080/21645515.2023.2258567 -
The Journal of Medical Investigation :... 2021Aim : We investigated whether preoperative or postoperative inflammatory markers and psoas muscle index (PMI), and their change after surgery, could predict...
Aim : We investigated whether preoperative or postoperative inflammatory markers and psoas muscle index (PMI), and their change after surgery, could predict postoperative recurrence in gastric cancer (GC). Methods : Thirty-five patients who underwent curative gastrectomy for pStage II and III GC were retrospectively reviewed. The relationship between neutrophil-lymphocyte ratio (NLR), prognostic nutritional index (PNI), Glasgow Prognostic Score (GPS), and PMI, as well as postoperative recurrence, was analyzed presurgery and at 6 months after surgery. Results : In the preoperative data, there was a significant association between postoperative recurrence and high NLR, low total protein, low albumin, low PNI, and high GPS. In the data from 6 months after surgery, there was a significant association between postoperative recurrence and high NLR, high C-reactive protein, and high GPS. The reduction in PMI at 6 months after surgery relative to preoperative data was significantly greater in the cases with recurrence than in those without recurrence. No patients whose PMI increased compared with presurgery had recurrence. Conclusions : The postoperative reduction in PMI at 6 months after surgery relative to presurgery could be a predictive marker of recurrence after curative gastrectomy for patients with pStage II and III GC. J. Med. Invest. 68 : 119-124, February, 2021.
Topics: Gastrectomy; Humans; Lymphocytes; Neoplasm Recurrence, Local; Neutrophils; Prognosis; Psoas Muscles; Retrospective Studies; Stomach Neoplasms
PubMed: 33994455
DOI: 10.2152/jmi.68.119 -
Journal of Cachexia, Sarcopenia and... Aug 2017
Topics: Female; Humans; Muscles; Ovarian Neoplasms; Psoas Muscles; Sarcopenia
PubMed: 28675689
DOI: 10.1002/jcsm.12221