Body composition and survival in the early clinical trials setting

• Published in: European journal of cancer (1990) Vol. 49; no. 15; pp. 3068 - 3075
• Main Authors: Veasey Rodrigues, H, Baracos, V.E, Wheler, J.J, Parsons, H.A, Hong, D.S, Naing, A, Fu, S, Falchoock, G, Tsimberidou, A.M, Piha-Paul, S, Chisholm, G, Kurzrock, R
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-10-2013; Elsevier
• Subjects: Biological and medical sciences; Body Composition; Clinical Trials, Phase I as Topic - methods; Female; Hematology, Oncology and Palliative Medicine; Humans; Male; Medical sciences; Middle Aged; Neoplasms - mortality; Neoplasms - pathology; Pharmacology. Drug treatments; Phase I clinical trial; Prognostic score; Sarcopenia; Survival Analysis; Treatment Outcome; Tumors; Sarcopenia; Prognostic score; Phase I clinical trial; Body composition; Score; Cancerology; Prognosis; Phase I trial; Clinical trial; Early; Survival
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2013.06.026

Abstract Purpose Delineate the relationships between body composition parameters, 90-day mortality and overall survival, and correlate them with known prognostic factors in an early clinical trials clinic. Patients and methods We studied 306 consecutive patients with various tumours; body composition was analysed by computerised tomography images. Survival was measured from the first clinic visit, at 90-day period and until death/last follow-up visit. Results Median patient age was 56 years; 159 patients were men. Ninety-day mortality rate was 12%. Median overall survival was 9 months. In multivariate analyses, high MD Anderson Cancer Center (MDACC) score ( p < 0.0001) [lactate dehydrogenase (LDH) > normal, albumin < normal, Eastern Cooperative Oncology Group (ECOG) performance status > 1, metastatic sites > 2, gastrointestinal (GI) tumours], low skeletal muscle index (SMI) ( p = 0.0406) and male gender ( p = 0.0077) were independent predictors of poor survival. If Royal Marsden Hospital (RMH) score (LDH > normal, albumin < normal, metastatic sites > 2) was used in lieu of MDACC score, it was also significant ( p = 0.0003). Including SMI and gender in the MDACC or RMH score improved the accuracy of the original model ( p = 0.006 and p = 0.0037, respectively). Conclusion Patients with low SMI have shorter survival. Gender and SMI strengthens the accuracy of MDACC or RMH scores as prognostic tools. Prospective validation of these findings is warranted.