Sarcopenia is a negative prognostic factor in localized extremities/trunk wall soft tissue sarcomas.
Tiziana Robba, Vito Chianca, Martina Rabino, Edoardo Cesaro, Francesca Molea, Antonella Boglione, Gian Luca Desi, Pietro Pellegrino, Michele Boffano, Simone De Meo, Alessandra Merlini, Federica Santoro, Alessandra Linari, Mario Levis, Sergio Sandrucci, Alessandro Comandone, Giovanni Grignani, Raimondo Piana, Lorenzo D'Ambrosio
Author Information
Tiziana Robba: Radiologia, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Vito Chianca: Clinica di Radiologia EOC IIMSI, Lugano, Switzerland.
Martina Rabino: Universit�� degli Studi di Torino Dipartimento di Oncologia, Italy; AOU San Luigi Gonzaga, Orbassano (Torino), Italy. Electronic address: martina.rabino@unito.it.
Edoardo Cesaro: Department of Precision Medicine, Universit�� degli Studi della Campania "L. Vanvitelli", Italy.
Francesca Molea: Radiologia, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Antonella Boglione: SC Oncologia ASL Citt�� di Torino, Ospedale San Giovanni Bosco, Italy.
Gian Luca Desi: Radiologia, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Pietro Pellegrino: Ortopedia Oncologica, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Michele Boffano: Ortopedia Oncologica, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Simone De Meo: Ortopedia Oncologica, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Alessandra Merlini: Universit�� degli Studi di Torino Dipartimento di Oncologia, Italy; AOU San Luigi Gonzaga, Orbassano (Torino), Italy.
Federica Santoro: Anatomia Patologica, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Alessandra Linari: Anatomia Patologica, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Mario Levis: Universit�� degli Studi di Torino Dipartimento di Oncologia, Italy; Radioterapia, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Sergio Sandrucci: SSD Chirurgia dei Sarcomi e Tumori Rari Viscerali, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Alessandro Comandone: SC Oncologia ASL Citt�� di Torino, Ospedale San Giovanni Bosco, Italy.
Giovanni Grignani: Oncologia Medica, AOU Citt�� della Salute e della Scienza di Torino, Italy; Medical Oncology, Candiolo Cancer Institute-FPO, IRCCS, Candiolo, Italy.
Raimondo Piana: Ortopedia Oncologica, Ospedale CTO, AOU Citt�� della Salute e della Scienza di Torino, Italy.
Lorenzo D'Ambrosio: Universit�� degli Studi di Torino Dipartimento di Oncologia, Italy; AOU San Luigi Gonzaga, Orbassano (Torino), Italy.
OBJECTIVE: Sarcopenia is an emerging determinant of oncologic patients' prognosis, but few data are available in extremities and trunk wall soft tissue sarcomas (ESTS). The aim was to evaluate sarcopenia impact on outcomes of patients affected by ESTS. METHODS: Through SliceOMatic software we selected cross-sectional skeletal muscle area (SMA), subcutaneous fat area (SFA) and visceral fat area (VFA) on a basal CT-slice at level of the third lumbar vertebra. Muscle density (MD) was computed in Hounsfield units (HU). Skeletal mass index (SMI, cm/m) was computed by normalizing SMA for the square of patient's height. Cut-offs for SMI were 52 and 39 cm/m for men and women, respectively, while we used median values for MD, SFA and VFA. We explored the correlation of the different parameters with post-surgical complications and survival outcomes (Kaplan-Meier method). RESULTS: 268 patients were included. Median SMAs, SMIs and MD were 155.7 cm, 51.2 cm/m, and 33.8 HU for men, 91.4 cm, 39.2 cm/m, and 30.4 HU for women. Sarcopenia rate was not significantly higher in patients ���65 years nor according to baseline prognostic factors (Sarculator app). Overall survival (OS) was significantly worse for sarcopenic patients: median OS 111.7 months (95%CI 72.8-150.6) vs not reached (NR; HR = 1.55, 95%CI:1.00-2.41, p = 0.049) for low-vs high-SMI; median OS 79.6 months (38.6-120.6) vs NR (HR 2.11, 1.34-3.34, p = 0.001) for low-vs high-MD, respectively. Sarcopenic patients showed increased post-surgical complications (30.5 % vs 17.0 %, p = 0.073). CONCLUSION: Although retrospective, our study suggests to further explore sarcopenia as a negative prognostic factor in ESTS patients.
