Abstract 5419
Background
Multiple mechanisms can directly influence body compositions (bcomp) in cancer: tumor-dependent chronic inflammation, leading to (a) anorexia and multiple neuroendocrine changes, (b) patient-dependent treatment related effects, and (c) in esophageal cancer, mechanical alterations with weight loss. Supportive management depends on understanding the cancer frailty determinants that lead to poor outcomes.
Methods
We retrospectively identified MEC patients (pts) treated in Toronto, Canada (2007-2014). Bcomp was assessed at presentation, using computed tomography, and included skeletal muscle index (SMI), visceral (VA) and subcutaneous adiposity (SA). Two outcome-blinded radiologists (Intraclass correlation, 0.92-1.00) assessed the L3 level, using SliceOMatic software. Published sex and BMI-dependent Bcomp cut-offs were used to define cancer associated sarcopenia. Cox proportional hazard models generated adjusted hazard ratios (aHR) and Kaplan-Meier curves estimated survival.
Results
Of 127 pts, 83% were male; 94% Caucasian; median age at diagnosis 61y (29-88); 80% were stage IV de novo. Mean body mass index (BMI) was 24.7; 69%/27%/3% were adeno/squamous cell /large cell carcinoma. Median overall (OS) and progression free survival (PFS) were: 6.4 (OS) and 1.5 mos (PFS). Median follow-up time was 5.6 mos. 49% were sarcopenic at baseline; of 44 pts with BMI > =25, 41% were sarcopenic. Univariable analyses identified albumin, LDH, and arcopenia as being inversely associated with OS and PFS. Multivariable models showed that sarcopenia was independently associated with worse OS (aHR=1.74, 95%CI 1.06-2.86, p = 0.03), and worse PFS (aHR=1.95, 95%CI 1.10-3.44, p = 0.02). In 76 pts receiving chemotherapy at diagnosis, less total adiposity (VA+SA) showed a trend towards worse OS (aHR=0.99 95%CI 0.99-1.00 p = 0.07 as continuous variable).
Conclusions
Sarcopenia at baseline is inversely related with OS and PFS in MEC. Our MEC patients had a higher incidence of sarcopenic obesity compared to cancer populations in the literature (9%). Future studies are needed to better characterize muscle and adiposity underlying biological importance in MEC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3006 - Nal-iri/lv5-fu versus paclitaxel as second-line therapy in patients with metastatic esophageal squamous cell carcinoma (OESIRI-PRODIGE 62): A FFCD multicenter, randomized, phase II study.
Presenter: Violaine Randrian
Session: Poster Display session 2
Resources:
Abstract
3697 - The expression of Versican and its role in pancreatic neuroendocrine tumor
Presenter: Zhao Sun
Session: Poster Display session 2
Resources:
Abstract
6073 - Characteristics of patients with thyroid carcinoma in the united states
Presenter: Dina El-Habashy
Session: Poster Display session 2
Resources:
Abstract
2124 - The discrimination of pituitary adenomas and craniopharyngioma on MRI: from image features to texture features
Presenter: Hanyue Xu
Session: Poster Display session 2
Resources:
Abstract
3786 - Proportion of Peripheral Lymphocyte Subsets Correlates with the Progression-free Survival and Metastatic Status of Pancreatic Neuroendocrine Tumor Patients
Presenter: Yitao Gong
Session: Poster Display session 2
Resources:
Abstract
2263 - Immunohistochemical expression of ER-α and PR in papillary thyroid carcinoma
Presenter: Enas Elkhouly
Session: Poster Display session 2
Resources:
Abstract
4386 - SILVELUL Project: Immunohistochemical panel analyses as potential predictive and prognostic factors in Pancreatic Neuroendocrine Tumors (PanNET) Treated with CAPTEM or Everolimus
Presenter: Ana De Jesus-Acosta
Session: Poster Display session 2
Resources:
Abstract
2302 - Carcinoid heart disease (CHD): the CRUSOE-NETs, a prospective cohort study from the French Group of Endocrine Tumors (GTE)
Presenter: Kathleen Dekeister Geoffroy
Session: Poster Display session 2
Resources:
Abstract
5749 - Safety of high doses of somatostatin analogs in well differentiated NENs in elderly
Presenter: Massimiliano Cani
Session: Poster Display session 2
Resources:
Abstract
3931 - Differences in multikinase inhibitors (MKI) toxicity profile according to gender. A pooled analysis of three phase II trials with lenvatinib, pazopanib and sorafenib in patients (pts) with advanced gastroenteropancreatic (GEP) neuroendocrine tumors (NETs).
Presenter: Jorge Hernando Cubero
Session: Poster Display session 2
Resources:
Abstract