The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma
Abstract Background The prognostic and predictive value of obesity and sarcopenia remains poorly defined in patients with high-risk soft tissue sarcoma (HR-STS). We sought to correlate clinical outcomes with CT-based body composition parameters in patients with HR-STS undergoing a multimodal preoper...
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BMC
2025-04-01
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| Online Access: | https://doi.org/10.1186/s12885-025-14050-x |
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| author | Luc M. Berclaz Dorit Di Gioia Michael Völkl Vindi Jurinovic Alexander Klein Hans Roland Dürr Thomas Knösel Bianca Teodorescu Stefan Enßle Michaela Rippl Michael von Bergwelt-Baildon Wolfgang G. Kunz Lars H. Lindner Anton Burkhard-Meier |
| author_facet | Luc M. Berclaz Dorit Di Gioia Michael Völkl Vindi Jurinovic Alexander Klein Hans Roland Dürr Thomas Knösel Bianca Teodorescu Stefan Enßle Michaela Rippl Michael von Bergwelt-Baildon Wolfgang G. Kunz Lars H. Lindner Anton Burkhard-Meier |
| author_sort | Luc M. Berclaz |
| collection | DOAJ |
| description | Abstract Background The prognostic and predictive value of obesity and sarcopenia remains poorly defined in patients with high-risk soft tissue sarcoma (HR-STS). We sought to correlate clinical outcomes with CT-based body composition parameters in patients with HR-STS undergoing a multimodal preoperative therapy. The impact of radiologic and histopathologic response to preoperative treatment was correlated with individual fat and muscle distribution. Methods Patients with locally advanced non-abdominal HR-STS and treatment with preoperative chemotherapy + regional hyperthermia (RHT) +/- radiotherapy (RT) followed by surgery between 2015 and 2022 were retrospectively evaluated. Body composition parameters measured on baseline CT scans were correlated with clinical outcomes including event-free survival (EFS) and overall survival (OS) as well as radiologic and histopathologic treatment response. Results A total of 85 patients were included. Body composition parameters showed no significant correlation with radiologic or histopathologic treatment response. High total fat indices such as the total fat index (TFI, HR 3.56, p = 0.005) and high total fat to muscle ratio (FMR, HR 3.22, p = 0.020) were strongly associated with poor OS. Parameters for sarcopenia including skeletal muscle index (SMI) were not significantly linked to survival outcomes. Conclusion High fat indices and a high FMR are strong predictors of poor OS in patients with HR-STS. Larger studies are warranted to further clarify the prognostic impact of sarcopenia and the predictive value of body composition parameters on preoperative treatment response. |
| format | Article |
| id | doaj-art-08989a6eed994dbd8ccfc9b7d0e8b11b |
| institution | DOAJ |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-08989a6eed994dbd8ccfc9b7d0e8b11b2025-08-20T03:06:51ZengBMCBMC Cancer1471-24072025-04-0125111110.1186/s12885-025-14050-xThe impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcomaLuc M. Berclaz0Dorit Di Gioia1Michael Völkl2Vindi Jurinovic3Alexander Klein4Hans Roland Dürr5Thomas Knösel6Bianca Teodorescu7Stefan Enßle8Michaela Rippl9Michael von Bergwelt-Baildon10Wolfgang G. Kunz11Lars H. Lindner12Anton Burkhard-Meier13Department of Internal Medicine III, University Hospital, LMU MunichDepartment of Internal Medicine III, University Hospital, LMU MunichDepartment of Internal Medicine III, University Hospital, LMU MunichInstitute for Medical Information Processing, Biometry, and Epidemiology, University Hospital, LMU MunichOrthopaedic Oncology, Department of Orthopedics and Trauma Surgery, University Hospital, LMU MunichOrthopaedic Oncology, Department of Orthopedics and Trauma Surgery, University Hospital, LMU MunichInstitute of Pathology, LMU MunichDepartment of Internal Medicine II, University Hospital, LMU MunichDepartment of Internal Medicine II, University Hospital, LMU MunichDepartment of Internal Medicine IV, University Hospital, LMU MunichDepartment of Internal Medicine III, University Hospital, LMU MunichDepartment of Radiology, University Hospital, LMU MunichDepartment of Internal Medicine III, University Hospital, LMU MunichDepartment of Internal Medicine III, University Hospital, LMU MunichAbstract Background The prognostic and predictive value of obesity and sarcopenia remains poorly defined in patients with high-risk soft tissue sarcoma (HR-STS). We sought to correlate clinical outcomes with CT-based body composition parameters in patients with HR-STS undergoing a multimodal preoperative therapy. The impact of radiologic and histopathologic response to preoperative treatment was correlated with individual fat and muscle distribution. Methods Patients with locally advanced non-abdominal HR-STS and treatment with preoperative chemotherapy + regional hyperthermia (RHT) +/- radiotherapy (RT) followed by surgery between 2015 and 2022 were retrospectively evaluated. Body composition parameters measured on baseline CT scans were correlated with clinical outcomes including event-free survival (EFS) and overall survival (OS) as well as radiologic and histopathologic treatment response. Results A total of 85 patients were included. Body composition parameters showed no significant correlation with radiologic or histopathologic treatment response. High total fat indices such as the total fat index (TFI, HR 3.56, p = 0.005) and high total fat to muscle ratio (FMR, HR 3.22, p = 0.020) were strongly associated with poor OS. Parameters for sarcopenia including skeletal muscle index (SMI) were not significantly linked to survival outcomes. Conclusion High fat indices and a high FMR are strong predictors of poor OS in patients with HR-STS. Larger studies are warranted to further clarify the prognostic impact of sarcopenia and the predictive value of body composition parameters on preoperative treatment response.https://doi.org/10.1186/s12885-025-14050-xRECISTEORTC-STBSGChemotherapyRegional hyperthermiaSoft tissue sarcomaSkeletal muscle index |
| spellingShingle | Luc M. Berclaz Dorit Di Gioia Michael Völkl Vindi Jurinovic Alexander Klein Hans Roland Dürr Thomas Knösel Bianca Teodorescu Stefan Enßle Michaela Rippl Michael von Bergwelt-Baildon Wolfgang G. Kunz Lars H. Lindner Anton Burkhard-Meier The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma BMC Cancer RECIST EORTC-STBSG Chemotherapy Regional hyperthermia Soft tissue sarcoma Skeletal muscle index |
| title | The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma |
| title_full | The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma |
| title_fullStr | The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma |
| title_full_unstemmed | The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma |
| title_short | The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma |
| title_sort | impact of ct based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high risk soft tissue sarcoma |
| topic | RECIST EORTC-STBSG Chemotherapy Regional hyperthermia Soft tissue sarcoma Skeletal muscle index |
| url | https://doi.org/10.1186/s12885-025-14050-x |
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