Associations between sarcopenia and clinical outcomes in men with metastatic castrate-resistant prostate cancer.
Notice bibliographique
Résumé
12056 Background: Understanding the impact of sarcopenia on clinical outcomes in patients with metastatic cancer will assist clinicians with risk stratification, treatment decision-making, and inform the need for targeted supportive care strategies. Our objective was to comprehensively assess sarcopenia using measures of muscle mass (radiographically) and function (i.e., muscle strength and walking speed) and examine its impact on severe treatment toxicity, time to first emergency room (ER) visit, prostate-specific antigen (PSA) progression, radiographic progression, and overall mortality in men initiating androgen receptor-axis targeted therapy (ARAT) or chemotherapy for mCRPC. Methods: This was a secondary analysis of a prospective observational study of older men with mCRPC at the Princess Margaret Cancer Centre. Sarcopenia was defined as the combination of low muscle strength (grip strength < 35.5kg), slowness (walking speed < 0.8m/s), and low muscle quantity or quality prior to treatment initiation. The skeletal muscle index and skeletal muscle density were assessed through computed tomography scans prior to ARAT or chemotherapy initiation to determine muscle quantity and quality, respectively, using published cut-offs. Severe treatment toxicity, unplanned healthcare use, and disease progression were assessed from treatment initiation until treatment termination or loss to follow up. The associations between sarcopenia and severe treatment toxicity (i.e., grade 3+ toxicity) were assessed using multivariable logistic regression. Survival analyses were used to assess the impact of sarcopenia on the time to first ER visit, PSA progression, radiographic progression, and overall mortality. An interaction term for sarcopenia by treatment was introduced in all multivariable models and when necessary, an analysis by treatment was performed. Results: In total, 110 men participated, of whom 30 (27.3%) had sarcopenia prior to initiating treatment. Sarcopenia was associated with severe treatment toxicity (adjusted odds ratio (aOR) = 6.26, 95%CI = 1.17-33.58, P = 0.032) and time to first ER visit (adjusted hazard ratio (aHR) = 4.41, 95%CI = 1.26-15.43, p = 0.020) in the group that was initiating ARAT but not chemotherapy. Sarcopenia was a significant predictor of radiographic progression (aHR = 2.39, 95%CI = 1.06-5.36, p = 0.035) and overall mortality (aHR = 2.44, 95%CI = 1.17-5.08, p = 0.018) in the entire cohort. Conclusions: Sarcopenia may predict severe treatment toxicity and emergency room visits in men starting ARAT for mCRPC. Additionally, sarcopenia predicts radiographic progression and overall mortality regardless of treatment type in men with mCRPC. Confirmation is needed from large-scale studies. Assessment of sarcopenia can assist clinicians in treatment decision making while identifying high-risk patients that require targeted supportive care strategies.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».