Abstract
ObjectivesTo evaluate the prognostic relevance of temporal muscle thickness (TMT) in brain metastasis patients.MethodsWe retrospectively analysed TMT on magnetic resonance (MR) images at diagnosis of brain metastasis in two independent cohorts of 188 breast cancer (BC) and 247 non-small cell lung cancer (NSCLC) patients (overall: 435 patients).ResultsSurvival analysis using a Cox regression model showed a reduced risk of death by 19% with every additional millimetre of baseline TMT in the BC cohort and by 24% in the NSCLC cohort. Multivariate analysis included TMT and diagnosis-specific graded prognostic assessment (DS-GPA) as covariates in the BC cohort (TMT: HR 0.791/CI [0.703–0.889]/p < 0.001; DS-GPA: HR 1.433/CI [1.160–1.771]/p = 0.001), and TMT, gender and DS-GPA in the NSCLC cohort (TMT: HR 0.710/CI [0.646–0.780]/p < 0.001; gender: HR 0.516/CI [0.387–0.687]/p < 0.001; DS-GPA: HR 1.205/CI [1.018–1.426]/p = 0.030).ConclusionTMT is easily and reproducibly assessable on routine MR images and is an independent predictor of survival in patients with newly diagnosed brain metastasis from BC and NSCLC. TMT may help to better define frail patient populations and thus facilitate patient selection for therapeutic measures or clinical trials. Further prospective studies are needed to correlate TMT with other clinical frailty parameters of patients.Key Points• TMT has an independent prognostic relevance in brain metastasis patients.• It is an easily and reproducibly parameter assessable on routine cranial MRI.• This parameter may aid in patient selection and stratification in clinical trials.• TMT may serve as surrogate marker for sarcopenia.
Highlights
Brain metastases are a frequent occurrence, and affect up to 40% of cancer patients during their disease course
This study aimed to investigate the prognostic role of temporal muscle thickness (TMT) measured on routinely obtained magnetic resonance (MR) images of the brain in patients with brain metastases
We selected clearly defined patient cohorts of the most common tumour types that are responsible for CNS spread, and included only patients with full clinical follow-up and availability of adequate cranial magnetic resonance imaging (MRI) at the diagnosis of brain metastasis
Summary
Brain metastases are a frequent occurrence, and affect up to 40% of cancer patients during their disease course. Therapy strategies include neurosurgical resection, radiation therapy (whole-brain radiotherapy or stereotactic radiosurgery) and systemic therapies depending on the number, location and size of CNS lesions, the extracranial disease status, the patient’s clinical condition and histological and molecular tumour characteristics [3]. Brain metastases as a result of NSCLC and BC are generally considered incurable and are associated with poor median overall survival times. Individual survival times show a high variability and range from 3 to 14.8 months in NSCLC and 3.4 to 25.3 months in BC patients with brain metastases [4, 5]. Established prognostic scores consider clinical factors, such as the number of brain metastases, the extracranial tumour status and the Karnofsky performance scale for outcome prediction. More objective measures of the patient’s physical condition may help to improve outcome prediction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
