医学
危险系数
四分位间距
比例危险模型
原发性中枢神经系统淋巴瘤
内科学
单变量分析
置信区间
生存分析
泌尿科
外科
肿瘤科
多元分析
甲氨蝶呤
作者
Riccardo Leone,Giacomo Sferruzza,Teresa Calimeri,Sara Steffanoni,Gian Marco Conte,Francesco De Cobelli,Andrea Falini,Andrés J.M. Ferreri,Nicoletta Anzalone
标识
DOI:10.1016/j.ejrad.2021.109945
摘要
Objective To investigate the role of quantitative muscle biomarkers assessed with skeletal muscle index at the third lumbar vertebra (L3-SMI) and temporal muscle thickness (TMT) in predicting progression-free and overall survival in patients with primary central nervous system lymphoma (PCNSL) undergoing first-line high-dose methotrexate-based chemotherapy. Methods L3-SMI and TMT were calculated on abdominal CT and brain high-resolution 3D-T1-weighted MR images, respectively, using predefined validated methods. Standardized sex-specific cut-off values were used to divide patients in different risk categories. Kaplan-Meier plots were calculated, and survival analysis was performed using log-rank tests, univariate, and multivariable Cox-regression models, calculating hazard ratios (HR) and 95% confidence intervals (CI), also adjusting for potential confounders (age, sex, and performance status). Results Forty-three patients were included in this study. Median follow-up was 23 months (interquartile range 12–40); at median follow-up, rates of progression-free and overall survival for the cohort were 46% and 57%, respectively. Thirteen (30%) and 11 (26%) patients showed L3-SMI or TMT values below the predefined cut-offs. In Cox-regression multivariable analysis patients with low L3-SMI or TMT showed significantly worse progression-free (HR 4.40, 95% CI 1.66–11.61, p = 0.003; HR 4.40, 95% CI 1.68–11.49, p = 0.003, respectively) and overall survival (HR 3.16, 95% CI 1.09–9.11, p = 0.034; HR 4.93, 95% CI 1.78–13.65, p = 0.002, respectively) compared to patients with high L3-SMI or TMT. Conclusions Quantitative muscle mass evaluation assessed by both L3-SMI and TMT is a promising tool to identify PCNSL patients at high risk of negative outcome. Confirmatory studies on larger independent series are warranted.
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