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Sarcopenia as a prognostic factor among patients with stage III melanoma.

Publication ,  Journal Article
Sabel, MS; Lee, J; Cai, S; Englesbe, MJ; Holcombe, S; Wang, S
Published in: Ann Surg Oncol
December 2011

BACKGROUND: Several hypotheses proposed to explain the worse prognosis for older melanoma patients include different tumor biology and diminished host response. If the latter were true, then biologic frailty, and not age, should be an independent prognostic factor in melanoma. METHODS: Our prospective institutional review board (IRB)-approved database was queried for stage III patients with computed tomography (CT) scans at time of lymph node dissection (LND). Psoas area (PA) and density (PD) were determined in semi-automated fashion. Kaplan-Meier (K-M) survival estimates and Cox proportional-hazard models were used to determine PA and PD impact on survival and surgical complications. RESULTS: Among 101 stage III patients, PD was significantly associated with both disease-free survival (DFS) (P = 0.04) and distant disease-free survival (DDFS) (P = 0.0002). Cox multivariate modeling incorporating thickness, age, ulceration, and N stage showed highly significant association with PD and both DFS and DDFS. DDFS was significantly associated with Breslow thickness (P = 0.04), number of positive nodes (P = 0.001), ulceration (P = 0.04), and decreasing muscle density (P = 0.01), with hazard ratio of 0.55 [95% confidence interval (CI) 0.35-0.87]. PD also correlated with surgical complications, with odds ratio (OR) of 1.081 [95% CI 1.016-1.150, P = 0.01]. CONCLUSIONS: Decreased psoas muscle density on CT, an objective measure of frailty, was as important a predictor of outcome as tumor factors in a cohort of stage III melanoma patients. On multivariate analysis, frailty, not age, was associated with decreased disease-free survival and distant disease-free survival, and higher rate of surgical complications.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

December 2011

Volume

18

Issue

13

Start / End Page

3579 / 3585

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Survival Rate
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Sarcopenia
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging
 

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Sabel, M. S., Lee, J., Cai, S., Englesbe, M. J., Holcombe, S., & Wang, S. (2011). Sarcopenia as a prognostic factor among patients with stage III melanoma. Ann Surg Oncol, 18(13), 3579–3585. https://doi.org/10.1245/s10434-011-1976-9
Sabel, Michael S., Jay Lee, Shijie Cai, Michael J. Englesbe, Stephen Holcombe, and Stewart Wang. “Sarcopenia as a prognostic factor among patients with stage III melanoma.Ann Surg Oncol 18, no. 13 (December 2011): 3579–85. https://doi.org/10.1245/s10434-011-1976-9.
Sabel MS, Lee J, Cai S, Englesbe MJ, Holcombe S, Wang S. Sarcopenia as a prognostic factor among patients with stage III melanoma. Ann Surg Oncol. 2011 Dec;18(13):3579–85.
Sabel, Michael S., et al. “Sarcopenia as a prognostic factor among patients with stage III melanoma.Ann Surg Oncol, vol. 18, no. 13, Dec. 2011, pp. 3579–85. Pubmed, doi:10.1245/s10434-011-1976-9.
Sabel MS, Lee J, Cai S, Englesbe MJ, Holcombe S, Wang S. Sarcopenia as a prognostic factor among patients with stage III melanoma. Ann Surg Oncol. 2011 Dec;18(13):3579–3585.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

December 2011

Volume

18

Issue

13

Start / End Page

3579 / 3585

Location

United States

Related Subject Headings

  • Young Adult
  • Tomography, X-Ray Computed
  • Survival Rate
  • Skin Neoplasms
  • Sentinel Lymph Node Biopsy
  • Sarcopenia
  • Prospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Staging