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M. Samarzija
Moderator of
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SH05 - WCLC 2016 Scientific Highlights - Chemotherapy, Targeted Therapy and Immunotherapy of Advanced NSCLC (ID 487)
- Event: WCLC 2016
- Type: Scientific Highlights
- Track: Advanced NSCLC
- Presentations: 3
- Moderators:J. Skřičková, M. Samarzija
- Coordinates: 12/07/2016, 07:30 - 08:30, Hall C1
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SH05.01 - Chemotherapy of Advanced NSCLC (ID 7129)
07:30 - 07:50 | Author(s): C.P. Belani
- Abstract
- Presentation
Abstract not provided
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SH05.02 - Targeted Therapy of Advanced NSCLC (ID 7130)
07:50 - 08:10 | Author(s): J. Spicer
- Abstract
- Presentation
Abstract not provided
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SH05.03 - Immunotherapy of Advanced NSCLC (ID 7131)
08:10 - 08:30 | Author(s): L. Crinò
- Abstract
- Presentation
Abstract not provided
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Author of
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OA02 - Novel Targets and Biomarkers in Malignant Pleural Mesothelioma (ID 369)
- Event: WCLC 2016
- Type: Oral Session
- Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
- Presentations: 1
- Moderators:L.E. Raez, M. Jakopovic
- Coordinates: 12/05/2016, 11:00 - 12:30, Stolz 2
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OA02.03 - Circulating Fibroblast Growth Factor 18 is Elevated in Malignant Pleural Mesothelioma Patients - A Multi-Institutional Study (ID 5988)
11:20 - 11:30 | Author(s): M. Samarzija
- Abstract
- Presentation
Background:
Malignant pleural mesothelioma (MPM) is a rare but devastating malignancy. Despite the search for new promising treatment approaches, the outcome for most MPM patients remains dismal. Therefore, the identification of novel biomarkers is urgently needed in order to identify patients with a better prognosis and to support personalized therapeutic decisions. In our previously published study, we were able to show that fibroblast growth factor 18 (FGF18) is overexpressed in MPM tissue specimens and cell models. The objective of this study was the evaluation of FGF18 as a circulating biomarker in MPM.
Methods:
Plasma was collected from 107 MPM patients at the time of diagnosis or before surgical resection. Samples were included from the Medical University of Vienna, University Hospital Center in Zagreb and from The Concord Repatriation General Hospital and Strathfield Private Hospital in Sydney. Samples from 49 healthy volunteers and from 8 patients with non-malignant pleural diseases served as controls. Circulating FGF18 was measured by enzyme-linked immunosorbent assay and correlated to clinical, pathologic and radiologic parameters.
Results:
Plasma FGF18 level was significantly elevated in MPM patients vs. healthy controls (P<0.0001). A slight increase of circulating FGF18 level was also detected in patients with pleuritis or fibrosis (vs. control, P=0.0067). Sarcomatoid (n=7) morphology was associated with high FGF18 levels when compared to the epithelioid (n=77) histology (P=0.0064). Importantly, MPM patients presenting with FGF18 levels below the median had a significantly longer overall survival when compared to those with high FGF18 levels (median survival 625 versus 382 d, P=0.0038). Data on multivariate analysis, disease-free survival, correlation with other biomarkers and tumor volume will be presented at the conference.
Conclusion:
Our findings reveal that FGF18 is a promising blood-derived candidate biomarker in MPM. Furthermore FGF18 may support the histological classification of MPM and the identification of MPM patients with poor prognosis. .
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P1.02 - Poster Session with Presenters Present (ID 454)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.02-049 - EGFR, KRAS and ALK Gene Alterations in Lung Cancer Patients in Croatia (ID 5943)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
Rates in targetable gene changes varies between different populations of lung cancer patients. Targetable gene changes include changes in EGFR and ALK gene, as well as KRAS gene. Primary aim of this study was to determine mutation status in purely Caucasian Croatian population.
Methods:
Rates in targetable gene changes varies between different populations of lung cancer patients. Targetable gene changes include changes in EGFR and ALK gene, as well as KRAS gene. Primary aim of this study was to determine mutation status in purely Caucasian Croatian population.
Results:
During 6 months period 324 newely diagnosed primary lung adenocarcinoma were tested. Out of 324 tested patients, 194 were males (60%) and 130 females (40%) mean age 64 years (range 35 to 88 years). Vast majority of patients were in stages 3 and 4 (more than 80%). Among males, 87% of patients were ever smokers, and among females 61% of patients were ever smokers. Significantly higher rates of evers smokers were recorded among males. EGFR mutations were present in 15.7% of patients (51 patients). There was a difference in EGFR mutation rates between males and females (5.6 vs 30.8%, p<0.0001). KRAS mutations (codones 12/12 and 61) were present in 35.8% (116) patients, and ALK translocation detected by IHC in 3.7% (12) patients.
Conclusion:
Molecular testing in primary lung adenocarcinoma patients was done in purely Caucasian Croatian population. EGFR mutation and ALK translocation rates were similar to previously published data. However, KRAS mutation rates were higher than previously published. This can be associated with high smoking rates in Croatian population.
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P1.04 - Poster Session with Presenters Present (ID 456)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Pulmonology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.04-025 - The Impact of Emergency Presentation on Survival of Lung Cancer Patients (ID 5964)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
A significant proportion of lung cancer patients are diagnosed through emergency department (ED), which is usually associated with poorer prognosis. We investigated the assocation between diagnosis of lung cancer after presentation through emergency department due to symptoms associated to lung cancer.
Methods:
Medical charts of patients with lung cancer patients newly diagnosed in Department for Respiratory Diseases Jordanovac, University Centre Zagreb in years 2012 and 2103 were reviewed. Overall survival was calculated and was compared between groups.
Results:
The medical charts of 951 males and 407 females, mean age 64 years (males 64.5, females 62) were reviewed. 292 out od 1359 patients (21,5%) were diagnosed with lung cancer after initial presentation through ED. The most common reasons for ED admissions were hemopytsis (in 31% of patients), pneumonia (16%), brain metastasis (15%), dyspnea (10%) and superior vena cava syndrome in 8% of patients. There were no differences in histology subptypes between two different routes of presentation (most common histology subtype was adenocarcinoma followed by squamous histology). Significantly higher proportion of patients diagnosed after initial diagnosis through ED were at presentation in stage IV (61 vs 44%, p<0.0001), poorer performance status (ECOG 3-4 vs ECOG 0-1, p<0.0001), significantly less patients underwent surgical resection (14 vs 5%, p<0.0001) and radiotherapy (56 vs 73%, p<0.0001). Median overall survival (mOS) was significantly lower in patients diagnosed through ED (6.0 vs 10.0 months, p<0.0001). In patients with non-small cell lung cancer (NSCLC) results were similar (mOS 6.0 vs 10.0 months, p<0.0001). In patients with small cell lung cancer (SCLC) mOS was also significantly worse (7.0 vs 9.0 months, p<0.0001) in patients diagnosed through ED.
Conclusion:
Higher stage, reduced access to surgical resection and radiotherapy, and significantly lower overall survival regardless of histology subtypes among lung cancer patients who presents through emergency department, stress out the importance of earlier diagnosis of lung cancer patients so that initial presentation through emergancy department can be reduced.
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-077 - Outcome of N2 Disease in NSCLC - A Single Institution Experience (ID 5041)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
There are many different therapy options available for stage IIIA-N2 NSCLC patients that were set by the NCCN guidelines. That is why we decided to evaluate outcome of different management strategies.
Methods:
Medical records of the patients diagnosed with lung cancer in Clinical hospital center Zagreb, Department for respiratory diseases Jordanovac during the year 2012 and 2013 were retrospectively collected and reviewed. Median overall survival (mOS) was measured and analyzed using the Kaplan-Meier and log-rank test.
Results:
There were 147 patients diagnosed with stage IIIA–N2 NSCLC, out of which 105 were male (71.4%), with median age 63 (40-102). Most of them were ex-smokers (54.4%), while only 9.5% never smoked cigarettes. Most of them had very good performance status at the time of diagnosis (ECOG 0-1 91.9%). 78 (53.1%) of the patients were diagnosed with adenocarcinoma, 62 (42.2%) with planocellular carcinoma, 6 (4.1%) with NSCLC-NOS and only 1 (0.7%) with adenosquamous carcinoma. mOS for all diagnosed lung cancer patients was 9 months and for NSCLC 8 months. mOS for IIIA-N2 NSCLC was 14 months. Our patients were treated with chemotherapy in 40.8% of the cases (mOS 11 months); sequential chemotherapy and irradiation in 25.2% (mOS 17 months); surgery, sequential chemotherapy and irradiation in 14.3% (mOS 26 months); surgery and adjuvant chemotherapy in 4.1% (mOS 15 months) and neoadjuvant chemotherapy and surgery in 1.4% (mOS 34 months) of the cases, while only 1.4% of all patients were treated with only surgical resection (mOS 4 months); (p=0.001).
Conclusion:
We analyzed the data collected at our department to assess the difference in outcomes of different strategies in IIIA – N2 management. The most of our patients were treated with platinum-based doublets only, followed by sequential chemotherapy and irradiation as a second most frequent therapy option. Only 21.8% of the patients were treated with surgery only or surgery combined with other forms of treatment. Only 1 patient underwent concurrent chemoradiation. The difference in overall survival between different therapy options showed highest mOS in patients treated with neoadjuvant chemotherapy and surgery followed by surgery and sequential chemotherapy and irradiation. Sequential chemotherapy and irradiation was superior to chemotherapy. The limitation of our study was a small number of patients in this specific subgroup, as well as small number of patients who underwent concurrent chemoradiation.
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P1.07 - Poster Session with Presenters Present (ID 459)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.07-013 - Treatment Related Side Effects of Oral Topotecan in Small Cell Lung Cancer (ID 5000)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
Lung cancer is the most common tumor in men and the second most common tumor in woman according to the latest data available from the Croatian National Cancer Registry. Approximately 20% of all lung cancers are categorized as small cell lung cancer (SCLC). Topotecan is recommended as second-line chemotherapy in treatment of SCLC. Topotecan can be administrated orally with the same effectiveness as parenteral.
Methods:
The aim of this study was to determine toxicity of oral topotecan in second line of chemotherapy and to establish the frequency of drug related admissions.
Results:
A total of 177 courses of therapy were administered to the 64 patients, 17 woman and 47 men, with SCLC patients ranging from 42 to 77 years with the mean age of 59.3. All the patients were treated in University Hospital Centre Zagreb from January 2012 to October 2015. Included patients had ECOG performance status of 0 or 1. Topotecan was administrated every 21 day, at the dose of 2.3 mg/m[2]/day, during 5 days. Average number of courses received was 2.8. Of all included patients 17 of them (26.5%) were admitted to hospital because of adverse events related to topotecan administration. The majority of patient hospitalizations (11 patients, 16.9%) was due to febrile neutropenia. Other reasons for hospitalization were severe diarrhea in 4 patients (6.2%), pneumonia in 1 patient (1.5%) and severe electrolyte imbalance in 1 patient (1.5%). Of 17 admissions to hospital 10 (58.9%) of them were after application of first chemotherapy cycle, 3 (17.6%) after second cycle and 4 (23.5%) after third cycle. Quantitative hematologic toxicities were assessed using the National Cancer Institute Common Toxicity Criteria. Anemia grade 3 or 4 occurred in 13 patients (20.3%). Grade 3 or 4 thrombocytpenia occurred in 7 patients (10.9%). Grade 3 or 4 neutropenia occurred in 16 patients (25%). Of other, non-hematologic adverse effects the most serious was grade 3 or 4 diarrhea that occurred in 5 patients (7.8%).
Conclusion:
although admission of oral topotecan is well tolerated it is related with high rate of hospitalizations due to myelotoxicity and gastrointestinal toxicity during therapy.
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-051 - Prognostic Value of the Pretreatment Peripheral Blood Markers in Patients with Non-Small Cell Lung Cancer (ID 6120)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
Lung cancer is the leading cause of cancer-related mortality worldwide. Regarding histological types, non-small cell lung cancer (NSCLC) represents 80% of all cases. In majority of all cases, NSCLC patients have locally advanced or metastatic disease at the time of diagnosis. Currently there is no predictive markers with clinical utility to guide treatment decisions in NSCLC patients undergoing therapy. We have compared mOS (median overall survival) before treatment (chemotherapy, radiotherapy or surgery) in patients with NSCLC regardless of the disease stage.
Methods:
Total of 1359 medical records of patients diagnosed with lung cancer Clinical hospital center Zagreb, Department of respiratory diseases Jordanovac during the year 2012 and 2013 were retrospectively collected and reviewed. Of that number, 1179 were NSCLC patients (all subtypes). We have analyzed normal and elevated biochemical markers: CRP (cut off value was 5.0 mg/L), leucocytes (cut of value was 10x10[9]/L), platelets (cut of value was 424x10[9]/L) and fibrinogen (cut off value was 4.1 g/L) in patients before treatment and calculated mOS (median overall survival). Since not all of 1179 patients performed pretreatment laboratory tests in our Department, we were unable to review laboratory findings of all diagnosed patients. mOS was measured and analyzed using the Kaplan-Meier and log-rank test.
Results:
We have found out that in case of elevated CRP and leukocytes values prior to treatment patients had lower mOS regardless of therapeutic modality. Additionally, elevated levels of fibrinogen and platelets do not affect mOS. From 1179 NSCLC patients, CRP was initially measured in 770. In 116 patients CRP was normal (<5mg/L) and in 654 elevated (>5mg/L). In patients with normal CRP mOS was 16 months, and in those with elevated CRP 10 months (p< 0.001). Leucocytes were initially measured in 842 patients. 444 patients had normal leucocyte values (<10 x10[9]/L) and 398 had elevated leucocytes (>10 x10[9]/L). Patients with normal leucocytes values had mOS of 13 months and those with elevated 10 months (p< 0.001).
Conclusion:
The prognostic impact of peripheral blood markers (CRP and leucocytes) supports the growing evidence of inflammation and cancer relationship. Elevated CRP and leucocytes before treatment are independent predictive factors for poorer mOS in NSCLC patients. The underlying mechanism by which these elevated markers affects the prognosis of lung cancer remains elusive.
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-009 - Brain Metastasis and Epidermal Growth Factor Receptor Mutations in Croatian Caucasians with Lung Adenocarcinoma (ID 5182)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
The brain is a common site of metastasis in non-small cell lung cancer (NSCLC). The aim of this study was two-fold: 1) to determine the incidence of brain metastasis (BM) in Caucasian lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations and 2) to evaluate the frequencies and potential relationship of the different EGFR mutations with BM.
Methods:
A retrospective cohort study was conducted at a Croatian tertiary hospital (Clinic for Respiratory Diseases “Jordanovac”) using data collected from medical records. Caucasian patients with primary NSCLC who were tested for EGFR mutation status between January 2014 and October 2015 were included.
Results:
Of 1040 NSCLC samples tested, 122 (11.7%) patients with lung adenocarcinoma harboured EGFR mutations; six EGFR positive (+) patients (four with BM) had repeat EGFR testing. The majority of EGFR mutants were females (n= 90, 77.6%), non-smokers (including never-smokers and former-smokers; n= 95, 92.2%), diagnosed with advanced disease (stage IIIB/IV) at first presentation (n= 75, 68.8%), and median age at initial diagnosis of primary lung cancer was 65 years (35 - 90). Twenty-three (19.8%) of 116 EGFR+ patients were diagnosed with BM; for six EGFR+ patients, data about BM was missing. Most were 64 years of age or younger (n= 15, 65.2%) at diagnosis of BM (median age: 62 years, 48 - 72). Synchronous BM disease at initial diagnosis of lung cancer was found in 43.5% of EGFR+ patients with BM (n= 10). There were more EGFR+ women with BM (n= 20, 87%) than men. Single exon 19 deletion and exon 21 L858R mutations were the most common subtypes in both EGFR+ patients without BM (n= 44, 47.3% and n= 27, 27.8%, respectively) and with BM (n= 13, 56.5% and n= 5, 21.7%, respectively). One BM patient (4.3%) had a double mutation (exon 19 and 21), while six non-BM patients (6.2%) had simultaneous pairings, most commonly between exon 19 and 20 (n=3, 3.1%). Although exon 18 mutations were seen in six patients without BM (6.2%), none were found in BM+EGFR+ patients. Exon 20 T790M mutation occurred in 17.4% of BM patients (n= 4) versus 15.3% of non-BM patients (n= 15). Rare EGFR double mutations (exon 18 and 20) were found in two non-BM patients (2.2%).
Conclusion:
Larger long-term prospective studies to explore and confirm these results in BM+EGFR+ patients are warranted. In the era of precision oncology, molecular testing of EGFR mutations may further clarify the pathogenesis of lung cancer-associated BM.
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-114 - Second Line Treatment of EGFR Positive Lung Adenocarcinoma - Our Experience (ID 6064)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
EGFR testing and specific targeted therapy of lung adenocarcinoma is a standard worldwide. In Croatia, tirosin-kinase inhibitors (TKI)are allowed as a second-line therapy for EGFR positive (+) patients. We analysed the median overall survival (mOS) differences between TKI- and.conventional chemotherapy-treated patients as a second-line therapy.
Methods:
Medical records of patients diagnosed with lung adenocarcinoma and tested for specific mutations in Clinical hospital center Zagreb, Department for respiratory diseases Jordanovac, during the year 2013 and 2014, were retrospectively collected and reviewed. Median overall survival (mOS) was measured and analyzed using routine statistic tests.
Results:
A total of 334 patients were tested for EGFR mutations, 47 of whom came positive and 287 negative. There was signifficant difference between the two subgroups regarding some demographic categories: the majority (78,7%) of the EGFR + patients were female, as opposed to the EGFR - group. Also, the EGFR+ patients were older on average ath time of diagnosis.(66,04 vs 63,04 years). After recieving first line platinum based chemotherapy a total of 20 positive EGFR patients recieved second-line therapy. 15 were treated with TKI and 5 recieved pemetrexed. In the EGFR negative group, 100 patients received second-line therapy, 85 of whom recieved pemetrexed and the other 15 were treated with platinum- or gemcitabine- based chemotherapy. If analysing mOS of all the patients, there was statistically significant difference between the TKI-treated patients (mOS not met) compared to the other ones (mOS=20 months) (chi-square= 6,07; p=0,014). Also, if analysing only the EGFR positive patients, the mOS difference reached statistical significance, comparing the TKI-treated patients (mOS =24,3months) with those treated with pemetrexed. (mOS=15,7 months) (chi-square= 7,99; p=0,005)
Conclusion:
Our results showed the significance of molecular testing and specific TKI treatment of patients with EGFR positive lung adenocarcinoma, as they had a significatly better overall survival compared to patients treated with pemetrexed. The results are conclusive with the general experience and treatment recommendations, and should be implemented in every day praxis, i.e. enabling molecular testing and specific treatment for all EGFR+ patients, at least as a second-line therapy option, should be an imperative.
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P3.02c - Poster Session with Presenters Present (ID 472)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02c-019 - The Use of Metformin and the Incidence of Metastases at the Time of Diagnosis in Patients with Lung Cancer and Type 2 Diabetes (ID 6116)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
Lung cancer is often insidious disease. It usually produces only a few symptoms until the disease is advanced. At initial diagnosis 20% of patients have localized disease, 25% of patients have regional metastasis and 55% of patients have distant spread of disease. Metastasis is a process by which a small number of cancer cells undergo numerous alterations, which enables them to form secondary tumors at another and often multiple sites in the host. Recently, studies have suggested that cancer stem cells are the originators of metastasis. Cancer stem cells are small populations of slowly dividing, tretment – resistant , undifferentiated cancer cells that are being discovered in a different cancers. Metformin has proved to be effective in the treatment of glioblastomas and neuroblastomas, in vitro, by targeting their cancer stem cell population. Recently, studies have shown that metformin use is not associated with a decreased risk of lung cancer in patients with type 2 diabetes, but it has been suggested that metformin use is associated with improved survival among patients with stage IV NSCLC patients.
Methods:
The aim of our study was to compare incidence of metastasis in lung cancer patients (NSCLC and SCLC) that were treated with metformin and patients with lung cancer that were not treated with metformin. It is a retrospective analysis of lung cancer patients diagnosed at our department between January 1, 2012 and December 31 2013. and data were collected from our computerized base.
Results:
During the two-year period in our department there were 335 newly diagnosed lung cancer patients. Among them there were 25 (7%) patients with diabetes mellitus that were on therapy with metformin prior to lung cancer diagnosis for at least six months. We have proved significant difference between two groups in the incidence of patients with distant spread of disease (stage IV) at the time of diagnosis. Metformin group had a lower inicidence of stage IV at the time of diagnosis ( 44% vs 64%; x2 =4.14; p=0.041). The results did neither revealed a significant difference in total number of patients with distant spread nor in the type of metastasis.
Conclusion:
We have shown that patients that were treated with metformin had lower incidenece of distant metastases at the time of diagnosis. Further research should evaluate biologic mechanisms and test the effect of metformin on inhibiting the cancer spread in prospective clinical trials.
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P3.05 - Poster Session with Presenters Present (ID 475)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Palliative Care/Ethics
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.05-018 - Assessment of Skeletal Muscle Mass as a Predicitive Factor for Chemotherapy Toxicity and TTP in Advanced NSCLC Patients with Cancer Cachexia (ID 3889)
14:30 - 14:30 | Author(s): M. Samarzija
- Abstract
Background:
Cancer cachexia and sarcopenia are frequently observed in cancer patients and associated with poor survival. We evaluated prevalence of cachexia and sarcopenia in NSCLC patients, relation to chemotherapy toxicity and time to tumor progression (TTP).
Methods:
In a prospective study we included 100 Caucasian patients with advanced NSCLC referred consecutively to our Department before starting 1st line platinum-doublet chemotherapy. Anthropometric and body composition measurements - total muscle cross sectional area, lumbar skeletal muscle index (LSMI) were done. Skeletal muscle cross-sectional area was measured at the third lumbar vertebra by CT scan, sarcopenia was defined using a previously published cut-off point, and TTP was specified.
Results:
Among 100 recruited patients 67 were male, median age 64 years, BMI 24.5±4.5, weight 68±15 kg, weight loss in previous 6 months 7±6 kg (9.4±7.7%), 55 patients had CT images that met the criteria for analysis. Median total muscle cross-sectional area at L3 was 142.97±35.64 cm[2 ]and median skeletal muscle index was 52.03 cm[2]/m[2]. Male patients had statistically significant higher lumbar skeletal muscle area and LSMI than female (53.31 vs. 40.95 cm[2]/m[2], P<0.001). A very high proportion of men met the criteria for sarcopenia compared to women; 60.5% and 17%, respectively. There were 34.6% sarcopenic patients among male who met the criteria as overweigh. Good correlation was observed between BMI and LSMI (r=0.614). The prevalence of cachexia and sarcopenia in study cohort was 69% and 47%, respectively. There was no statistically significant difference between the groups in frequency of chemotherapy toxicity, between TTP in cachectic (187 days) and non-cachectic patients (167 days) (HR (95% CI) = 0.83 (0.48-1.43); P = 0.470) nor between sarcopenic (218 days) and non-sarcopenic patients (209 days).
Conclusion:
Cachexia and sarcopenia were not found to be predictors of chemotoxicity nor TTP. CT scan is a reliable method for obtaining and calculating muscle area, easily measurable, reproducible and usable without expensive software technology in everyday practice.
