Racial differences in body composition and survival among older adults with gastrointestinal malignancies.

Autor: Aleixo GFP; University of Pennsylvania, Department of Hematology and Oncology, Philadelphia, PA, United States of America. Electronic address: gabriel.aleixo@pennmedicine.upenn.edu., Hess DL; The University of Alabama at Birmingham, Department of Medicine, Birmingham, AL, United States of America., Fowler ME; The University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL, United States of America., Giri S; The University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America., Williams GR; The University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, United States of America.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2024 May; Vol. 15 (4), pp. 101747. Date of Electronic Publication: 2024 Mar 20.
DOI: 10.1016/j.jgo.2024.101747
Abstrakt: Introduction: Muscle and adipose tissue measures can be quantified from routinely obtained computed tomography (CT) images and are predictors of chemotherapy-related toxicities and survival among patients with gastrointestinal (GI) malignancies. Most studies to date have consisted of predominantly White patients, and the role of body composition among minoritized racial groups is unknown. We examined racial differences in body composition and survival among patients with GI malignancies.
Materials and Methods: This was a prospective cohort study of patients with GI malignancies. Single slices of axial CT images from L3 segments were analyzed using Slice-O-Matic software. The skeletal muscle area (cm 2 ) was divided by height to obtain the skeletal muscle index (SMI, cm 2 /m 2 ). Skeletal muscle radiodensity (SMD) in Hounsfield units (HU) was used for muscle composition. We compared body composition parameters between non-Hispanic (NH)-White and NH-Black participants. Cox models were used to examine the impact of body composition on survival. We proposed new race-specific cutoffs for body composition using optimal stratification.
Results: Five hundred forty patients were included, of which 24% were NH-Black. In Cox models stratified by race, each 5 cm 2 /m 2 decrease in SMI was associated with increase in risk of all-cause mortality in NH-Black patients (hazard ratio [HR] 1.25; 95% confidence interval [CI] 1.04-1.49 p = 0.02). With the existing cut points, neither sarcopenia nor myosteatosis was associated with worse survival. Using a new cutoff for sarcopenia in NH-Black patients, NH-Black patients with sarcopenia (HR 2.31 95%CI 1.10-4.88 p = 0.03) and myosteatosis (HR 2.63 95% CI 1.25-5.53 p = 0.01) had worse survival.
Discussion: NH-Black older patients with GI cancers and sarcopenia or myosteatosis have worse overall survival.
Competing Interests: Declaration of Competing Interest All authors report no conflict of interest.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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