Table 3.
Summary of studies investigating the association of body composition parameters and outcome in prostate cancer
| Author, year | Design | Patient | Time of assessment | Findings | |
|---|---|---|---|---|---|
| characteristics | |||||
| (Treatment) | |||||
| Pak et al., 2019 21 | Retrospective | 2042 | Preoperative | Low psoas muscle index is associated with increased risks of biochemical recurrence, distant metastasis, and overall mortality regardless of the BMI. | |
| localized PCa | |||||
| (radical prostatectomy) | |||||
| Mason et a., 2018 22 | Retrospective | 698 | Preoperative | Prevalence sarcopenia (55.6%) | |
| localized PCa | |||||
| (radical prostatectomy) | Sarcopenia (Skeletal muscle index < 55 cm2/m2) was not found to be independently associated with perioperative complications or oncologic outcomes. | ||||
| McDonald et al., 2017 10 | Retrospective | 171 | Before treatment | Lower subcutaneous adipose tissue density was associated with a lower rate of biochemical failure following definitive treatment. | |
| high‐risk PCaa | |||||
| (definitive RT+ADT) | |||||
| Kashiwagi et al., 2020 11 | Retrospective | 178 | Before treatment | High psoas muscle volume index is associated with longer overall survival. | |
| metastatic hormone‐naïve PCa | |||||
| (ADT) | |||||
| Pak et al., 2020 9 | Retrospective | 230 CRPCa | Before treatment | High skeletal muscle mass (median, 49.9 cm2/m2) is associated with reduced risk of disease progression and mortality in patients treated with Docetaxel but not those who received ADT. | |
| (docetaxel‐44, ADT‐86) | |||||
| Stangl‐Kremser et al., 2019 8 | Retrospective | 186 | Before treatment | Prevalence sarcopenia (82.8%) | |
| Low skeletal muscle volume is an independent prognostic factor for tumor progression. | |||||
| CRPCa | *Patients with high visceral to‐subcutaneous fat ratio tend to have shorter overall survival (p = .06) | ||||
| (docxetaxel+prednisone, prior ADT) | |||||
| Ohtaka et al., 2019 15 | Retrospective | 77 | Before treatment | Prevalence sarcopenia (34%) | |
| CRPCa | |||||
| (docetaxel) | Sarcopenia (Psoas muscle index < 5.7 cm2/m2) is an independent predictor of poor tolerance to docetaxel. | ||||
| Thekkekara et al., 2018 22 | Retrospective | 59 | Before and after treatment | Prevalence sarcopenia (57.6%) | |
| metastatic CSPCa | Significant loss of muscle mass and increase in adipose burden without changes in BMI following treatment. | ||||
| (ADT ± upfront docetaxel) | No significant change in body composition of patients who received docetaxel+ADT (n = 25) compared to those who received ADT alone (n = 34). | ||||
| Lee et al., 2018 5 | Retrospective | 282 | Before treatment | Subcutaneous fat index (>39.9 cm2/m2) is associated with higher progression‐free and cancer‐specific survival rates. | |
| CRPCa | |||||
| (docetaxel+ADT) | *Patients with high skeletal muscle index (52.4 cm2/m2) tend to have higher progression‐free and cancer‐specific survival rates (p = .08) | ||||
| Cushen et al., 2016 6 | Retrospective | 63 | Before treatment | Prevalence sarcopenia (47%) | |
| metastatic CRPCa | Docetaxel toxicity: Sarcopenia and low muscle attenuation are associated with neutropenia. Measurements of adiposity were not predictive of docetaxel toxicity. | ||||
| (docetaxel+ADT) | Survival: Neither sarcopenia nor sarcopenic obesity was associated with overall survival. High volume of visceral fat and BMI < 25 kg/m2 are associated with reduced survival. | ||||
| Wu et al., 2015 7 | Retrospective | 333 | Within 1 month from treatment initiation | High visceral to subcutaneous fat area ratio was associated with poor prognosis. | |
| metastatic CRPCa | |||||
| (docetaxel) | High visceral fat to muscle ratio and high BMI were associated with increased duration from starting docetaxel to death. | ||||
Abbreviations: ADT, androgen deprivation therapy; BMI, body mass index; CRPCa, castration‐resistant prostate cancer; CSPCa, castration‐sensitive prostate cancer; PCa, prostate cancer; PSA, prostate‐specific antigen; RT, radiotherapy.
a
High‐risk defined as PSA > 20 ng/ml, Gleason score ≥ 8, or extra‐prostatic extension.