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ABSTRACT: Background
Prognostic significance of adiposity, at the time of cancer diagnosis, on survival is not clear. Body mass index (kg?m-2) does not provide an appropriate assessment of body composition; therefore, the concept of the 'obesity paradox' needs to be investigated based on the prognostic significance of fat and muscle. Independent prognostic significance of adipose tissue in predicting mortality, importance of visceral and subcutaneous adiposity in the presence and absence of sarcopenia on survival, was investigated.Methods
Adiposity markers including total adipose index (TATI), visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI) were estimated for 1473 gastrointestinal and respiratory cancer patients and 273 metastatic renal cell carcinoma patients using computed tomography. Univariate and multivariate analysis to determine mortality hazard ratios (HR) were conducted using cox proportional hazard models.Results
Low SATI (SATI <50.0?cm2?m-2 in males and <42.0?cm2?m-2 in females) independently associated with increased mortality (HR: 1.26; 95% CI: 1.11-1.43; P<0.001) and shorter survival (13.1 months; 95% CI, 11.4-14.7) compared to patients with high SATI (19.3 months; 95% CI, 17.6-21.0; P<0.001). In the presence of sarcopenia, the longest survival was observed in patients with high subcutaneous adiposity.Conclusions
Subcutaneous adipose tissues appear to associate with reduction in mortality risk demonstrating the prognostic importance of fat distribution. The effect of sarcopenia on survival was more pronounced in patients with low subcutaneous adiposity.
SUBMITTER: Ebadi M
PROVIDER: S-EPMC5520211 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
Ebadi Maryam M Martin Lisa L Ghosh Sunita S Field Catherine J CJ Lehner Richard R Baracos Vickie E VE Mazurak Vera C VC
British journal of cancer 20170606 1
<h4>Background</h4>Prognostic significance of adiposity, at the time of cancer diagnosis, on survival is not clear. Body mass index (kg m<sup>-2</sup>) does not provide an appropriate assessment of body composition; therefore, the concept of the 'obesity paradox' needs to be investigated based on the prognostic significance of fat and muscle. Independent prognostic significance of adipose tissue in predicting mortality, importance of visceral and subcutaneous adiposity in the presence and absenc ...[more]