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Psoas mass index at the level of the third lumbar vertebra on computed tomography is a prognostic predictor for metastatic castration-sensitive prostate cancer

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Abstract

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.

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Authors and Affiliations

  1. Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan

    Shunsuke Owa, Takeshi Sasaki, Ryota Ikadai, Yusaku Tabata, Yushiro Takeuchi, Taketomo Nishikawa, Momoko Kato, Shinichiro Higashi, Yusuke Sugino, Satoru Masui, Kouhei Nishikawa & Takahiro Inoue

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  1. Shunsuke Owa
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  2. Takeshi Sasaki
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  3. Ryota Ikadai
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  4. Yusaku Tabata
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  5. Yushiro Takeuchi
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  6. Taketomo Nishikawa
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  7. Momoko Kato
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  8. Shinichiro Higashi
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  9. Yusuke Sugino
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  10. Satoru Masui
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  11. Kouhei Nishikawa
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  12. Takahiro Inoue
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Correspondence to Takahiro Inoue.

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Owa, S., Sasaki, T., Ikadai, R. et al. Psoas mass index at the level of the third lumbar vertebra on computed tomography is a prognostic predictor for metastatic castration-sensitive prostate cancer. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02514-2

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  • DOI: https://doi.org/10.1007/s10147-024-02514-2

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