Background

Computed tomography-defined low skeletal muscle mass is associated with oncological outcomes in patients with prostate cancer. However, its association with the outcomes of hormone-treated metastatic castration-sensitive prostate cancer remains unclear. We aimed to determine the association between metastatic castration-sensitive prostate cancer and psoas muscle parameters.

Methods

We retrospectively reviewed 121 patients with N1 and/or M1 metastatic castration-sensitive prostate cancer who underwent primary androgen deprivation therapy between 2005 and 2021, either by administration of luteinizing hormone-releasing hormone agonist/antagonist or by surgical castration accompanied by bicalutamide, a first-generation antiandrogen. Before treatment administration, the psoas muscle index at the level of the third lumbar vertebra (psoas muscle area [cm²]/height² [m²]) and the mean Hounsfield units of the psoas muscle were evaluated using non-contrast computed tomography and in relation to oncological outcomes.

Results

The median follow-up was 56.9 months. Furthermore, during follow-up, 82 (67.7%) and 53 (43.8%) patients progressed to castration-resistant prostate cancer and died, respectively. Multivariate analysis of castration-resistant prostate cancer-free survival and overall survival showed significant differences in the Gleason score, clinical N-stage, and psoas muscle index (median cutoff: 3.044 cm²/m²).

Conclusions

Pretreatment psoas muscle index is an independent predictor of poor castration-resistant prostate cancer-free survival and overall survival in patients with N1 and/or M1 metastatic castration-sensitive prostate cancer.

中文翻译：

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计算机断层扫描第三腰椎水平的腰肌质量指数是转移性去势敏感前列腺癌的预后预测因子

背景

计算机断层扫描定义的低骨骼肌质量与前列腺癌患者的肿瘤学结果相关。然而，其与激素治疗的转移性去势敏感型前列腺癌结果的关系仍不清楚。我们的目的是确定转移性去势敏感前列腺癌与腰肌参数之间的关联。

方法

我们回顾性审查了 121 名 N1 和/或 M1 转移性去势敏感型前列腺癌患者，这些患者在 2005 年至 2021 年间接受了原发性雄激素剥夺治疗，通过给予黄体生成素释放激素激动剂/拮抗剂或通过手术去势联合比卡鲁胺（首次） -一代抗雄激素。在治疗前，使用非造影计算机断层扫描评估第三腰椎水平的腰肌指数（腰肌面积 [cm ² ]/高度² [m ² ]）和腰肌的平均 Hounsfield 单位，与肿瘤学结果相关。

结果

中位随访时间为 56.9 个月。此外，在随访期间，分别有 82 名（67.7%）和 53 名（43.8%）患者进展为去势抵抗性前列腺癌并死亡。去势抵抗性前列腺癌无癌生存期和总生存期的多变量分析显示，格里森评分、临床 N 分期和腰肌指数（中位截止值：3.044 cm ² /m ²）存在显着差异。

结论

治疗前腰肌指数是 N1 和/或 M1 转移性去势敏感性前列腺癌患者去势抵抗性前列腺癌无生存率和总生存率较差的独立预测因子。