Genç Meme Kanserli Hastalarda Vücut Kompozisyonunun Prognostik Etkileri

Öz

Giriş/Amaç:Kanser hastalarında, vücut kompozisyonunun prognoz üzerindeki etkisi yeni bir klinik ilgi alanıdır. Evre 2 veya 3 obezite (VKİ> 35) olan hastalarda sağ kalım, bir meta-analizde kontrol gruplarına oranla daha kötü olarak bulunmuştur. BMI kategorisi, vücut kompozisyonunu tam olarak temsil etmez ve gerçek kas ve yağ miktarını belirlemek için kullanımı zordur. Bilgisayarlı tomografi (BT) vücut kompozisyonunu kesin olarak belirlemek için sık kullanılan bir yöntemdir. Gereç ve Yöntemler:Tüm karın kasları (psoas, diken omurga, kuadratus lumborum) dış ve iç oblik ve rektus abdominis dahil olmak üzere aksiyal BT görüntüleri toplam iskelet kası alanı (SMA) hesaplandı. Ayrıca, subkütanöz adipoz ve viseral adipoz doku dağılımı (VAT, SAT) alanlarının aksiyal BT görüntüleri, adipoz doku için -30 ila -190 eşik değerleri kullanılarak cm2 cinsinden hesaplanmıştır. Bulgular:Seksen dört kadın çalışmaya dahil edildi. Hastaların çoğu normal veya aşırı ağırlıklı idi. İnvaziv karsinom NST, çalışma popülasyonunun % 94'ünde baskın histolojik alt tiplerdi. Sarkopenik ve sarkopenik olmayan hastaların sayısı sırasıyla 11 ve 68 idi. Her iki gruptaki hastalar için ortalama genel sağkalıma (OS) takip süresinin sonunda ulaşılamasa da, gruplar arasındaki fark istatistiksel olarak anlamsızdı. Her iki grup için ortanca OS'ye ulaşılmadı, düşük ve yüksek VAT grupları arasındaki fark istatistiksel olarak anlamlıydı. Çoklu analizlerde VAT bağımsız bir risk faktörü olarak saptandı. Sonuç:Bu çalışmada sarkopeninin 40 yaşın altındaki meme kanseri hastalarında görülebildiğini ve prognostik bir etkisi olmadığını gösterdik.

Anahtar Kelimeler

• Sarkopeni
• Viseral Yağ Dokusu
• Genç Meme Kanseri
• Prognoz

The Effect of The Body Composition to Prognosis in Young Breast Cancer Patients

Abstract

Objective:In cancer patients, the effect of the body composition on prognosis is a new clinical area of interest. In patients with class 2 or 3 obesity (BMI >35), survival found to be worse control groups in a pooled analysis. BMI category is not truly representing body composition and hard to use to determine the true muscle and fat quantity. Computed tomography (CT) is a frequent method to determine body composition precisely. Methods:Axial CT images, including all abdominal muscles (psoas, erector spinae, quadratus lumborum) external and internal oblique and rectus abdominis) total skeletal muscle area (SMA), was calculated. Besides, axial CT images of the body fat subcutaneous adipose and visceral adipose tissue distribution (VAT, SAT) areas were calculated in cm2 using threshold values of -30 to -190 for adipose tissue. Results:Eighty-four women were included in the study. Most of the patients were normal or over-weighted. Invasive carcinoma NST was the dominant histological subtypes, with 94% of the study population. The count of the sarcopenic and non-sarcopenic patients was 11 and 68 respectively. Although the median OS cannot be reached at the end of the follow-up period for both groups, the difference between groups statistically insignificant. The median OS was not reached for both groups, the difference between low and high TVAT groups was statistically significant. In multivariate analysis, TVAT was found to be an independent risk factor. Conclusion:In this study, we demonstrate sarcopenia may be seen in patients with breast cancer under 40 years old, and it may not have a prognostic effect.

Keywords

• Sarcopenia
• Visceral adipose tissue
• Young Breast Cancer
• Prognosis

Kaynakça

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