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. 2021 Feb 2;13(3):566.
doi: 10.3390/cancers13030566.

Evaluation of the Temporal Muscle Thickness as an Independent Prognostic Biomarker in Patients with Primary Central Nervous System Lymphoma

Julia Furtner  1 , Karl-Heinz Nenning  2 , Thomas Roetzer  3 , Johanna Gesperger  3 , Lukas Seebrecht  3 , Michael Weber  1 , Astrid Grams  4 , Stefan L Leber  5 , Franz Marhold  6 , Camillo Sherif  7 , Johannes Trenkler  8 , Barbara Kiesel  9 , Georg Widhalm  9 , Ulrika Asenbaum  1 , Ramona Woitek  1 , Anna S Berghoff  10 , Daniela Prayer  1 , Georg Langs  2 , Matthias Preusser  10 , Adelheid Wöhrer  3
Affiliations

Evaluation of the Temporal Muscle Thickness as an Independent Prognostic Biomarker in Patients with Primary Central Nervous System Lymphoma

Julia Furtner et al. Cancers (Basel). .

Abstract

In this study, we assessed the prognostic relevance of temporal muscle thickness (TMT), likely reflecting patient's frailty, in patients with primary central nervous system lymphoma (PCNSL). In 128 newly diagnosed PCNSL patients TMT was analyzed on cranial magnetic resonance images. Predefined sex-specific TMT cutoff values were used to categorize the patient cohort. Survival analyses, using a log-rank test as well as Cox models adjusted for further prognostic parameters, were performed. The risk of death was significantly increased for PCNSL patients with reduced muscle thickness (hazard ratio of 3.189, 95% CI: 2-097-4.848, p < 0.001). Importantly, the results confirmed that TMT could be used as an independent prognostic marker upon multivariate Cox modeling (hazard ratio of 2.504, 95% CI: 1.608-3.911, p < 0.001) adjusting for sex, age at time of diagnosis, deep brain involvement of the PCNSL lesions, Eastern Cooperative Oncology Group (ECOG) performance status, and methotrexate-based chemotherapy. A TMT value below the sex-related cutoff value at the time of diagnosis is an independent adverse marker in patients with PCNSL. Thus, our results suggest the systematic inclusion of TMT in further translational and clinical studies designed to help validate its role as a prognostic biomarker.

Keywords: overall survival; primary central nervous system lymphoma; prognostic parameter; sarcopenia; temporal muscle thickness.

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Conflict of interest statement

M.P. has received honoraria for lectures, consultation, or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, and Tocagen. The following for-profit companies have supported clinical trials and contracted research conducted by M.P. with payments made to his institution: Böhringer-Ingelheim, Bristol-Myers Squibb, Roche, Daiichi Sankyo, Merck Sharp & Dome, Novocure, GlaxoSmithKline, and AbbVie. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Illustration of TMT assessments on T1-weighted contrast-enhanced magnetic resonance images: (A) a 60-year-old male patient with an overall survival of one month (median TMT = 5.75 mm) and (B) a 51-year-old male patient with an overall survival of 73 months (median TMT = 8.1 mm).
Figure 2
Figure 2
Kaplan–Meier survival curves for patients with TMT values below (black line) and above (dashed line) the sex-related cutoff values.
Figure 3
Figure 3
Forest plot to visualize the impact on all possible explanatory variables on overall survival (* p < 0.05; *** p < 0.001).
See this image and copyright information in PMC

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