Skeletal muscle status and survival among patients with advanced biliary tract cancer

Author:

Takaoka Shinya1,Hamada Tsuyoshi1,Takahara Naminatsu1,Saito Kei1,Endo Go1,Hakuta Ryunosuke1,Ishida Kota1,Ishigaki Kazunaga1,Kanai Sachiko1,Kurihara Kohei1,Oyama Hiroki1,Saito Tomotaka1,Sato Tatsuya1,Suzuki Tatsunori1,Suzuki Yukari1,Tange Shuichi1,Tokito Yurie1,Tateishi Ryosuke1,Nakai Yousuke2ORCID,Fujishiro Mitsuhiro1

Affiliation:

1. Graduate School of Medicine, The University of Tokyo

2. The University of Tokyo: Tokyo Daigaku

Abstract

Abstract Background Studies have demonstrated a prognostic role of sarcopenia (i.e., loss of skeletal muscle volume and functionality) in patients with various cancer types. In patients with biliary tract cancer, the quantity and quality of skeletal muscles and their serial changes have not been fully investigated in relation to survival outcomes. Methods We identified 386 patients with unresectable or recurrent biliary tract cancer and calculated skeletal muscle index (SMI) and skeletal muscle density (SMD) to estimate muscular quantity and quality, respectively, based on computed tomography images. Using the Cox regression model with adjustment for potential confounders, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) according to skeletal muscle status and its serial change. Results Compared to patients without sarcopenia, patients with sarcopenia had multivariable HRs of 1.56 (95% CI, 1.13–2.17; P = 0.008) and 1.23 (95% CI, 0.99–1.53; P = 0.059) for PFS and OS, respectively. SMD at baseline was associated with OS with a multivariable HR comparing the extreme quartiles of 1.54 (95% CI, 1.09–2.18; Ptrend = 0.010). A reduction in SMI rather than that in SMD was associated with OS. Progressive disease was a risk factor for reductions in SMI and SMD. Conclusions Skeletal muscle quantity and quality and their serial changes were associated with survival outcomes in patients with advanced biliary tract cancer. Our data highlight the importance of designing nutritional and physical interventions for improvements in skeletal muscle status in this population.

Publisher

Research Square Platform LLC

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