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Prognostic relevance of temporal muscle thickness as a marker of sarcopenia in patients with glioblastoma at diagnosis

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Abstract

Objectives

Temporal muscle thickness (TMT) is a surrogate marker of sarcopenia, correlated with survival expectancy in patients suffering from brain metastases and recurrent or treated glioblastoma. We evaluated the prognostic relevance of TMT measured on brain MRIs acquired at diagnosis in patients affected by glioblastoma.

Methods

We retrospectively enrolled 51 patients in our Institution affected by methylated MGMT promoter, IDH1–2 wild-type glioblastoma, who underwent complete surgical resection and subsequent radiotherapy with concomitant and maintenance temozolomide, from January 1, 2015, to April 30, 2017. The last clinical/radiological follow-up date was set to September 3, 2019. TMT was measured bilaterally on reformatted post-contrast 3D MPRAGE images, acquired on our 3-T scanner no more than 2 days before surgery. The median, 25th, and 75th percentile TMT values were identified and population was subdivided accordingly; afterwards, statistical analyses were performed to verify the association among overall survival (OS) and TMT, sex, age, and ECOG performance status.

Results

In our cohort, the median OS was 20 months (range 3–51). Patients with a TMT ≥ 8.4 mm (median value) did not show a statistically significant increase in OS (Cox regression model: HR 1.34, 95% CI 0.68–2.63, p = 0.403). Similarly, patients with a TMT ≥ 9.85 mm (fourth quartile) did not differ in OS compared to those with TMT ≤ 7 mm (first quartile). The statistical analyses confirmed a significant association among TMT and sex (p = 0.0186), but none for age (p = 0.642) and performance status (p = 0.3982).

Conclusions

In our homogeneous cohort of patients with glioblastoma at diagnosis, TMT was not associated with prognosis, age, or ECOG performance status.

Key Points

• Temporal muscle thickness (TMT) is a surrogate marker of sarcopenia and has been correlated with survival expectancy in patients suffering from brain metastases and recurrent or treated glioblastoma.

• We appraised the correlation among TMT and survival, sex, age at surgery, and performance status, measured on brain MRIs of patients affected by glioblastoma at diagnosis.

• TMT did not show any significant correlation with prognosis, age at surgery, or performance status, and its usefulness might be restricted only to patients with brain metastases and recurrent or treated glioblastoma.

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Abbreviations

ECOG:

Eastern Cooperative Oncology Group

GBM:

Glioblastoma

IDH:

Isocitrate dehydrogenase

MGMT:

O6-methylguanine-DNA methyltransferase

MPRAGE:

Magnetization-prepared rapid acquisition with gradient echo

OS:

Overall survival

PS:

Performance status

RT:

Radiotherapy

SMI:

Skeletal mass index

TMT:

Temporal muscle thickness

TMZ:

Temozolomide

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Training School in Radiology, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Riccardo Muglia

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Matteo Simonelli, Federico Pessina, Pasquale Persico, Angelo Dipasquale, Marta Scorsetti, Armando Santoro & Letterio S. Politi

  3. Oncology and Hematology Unit, Humanitas Clinical and Research Center – IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy

    Matteo Simonelli, Pasquale Persico, Elena Lorenzi, Angelo Dipasquale & Armando Santoro

  4. Department of Neurosurgery, Humanitas Clinical and Research Center – IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy

    Federico Pessina

  5. Biostatistic Unit, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy

    Emanuela Morenghi

  6. Department of Radiotherapy, Humanitas Clinical and Research Center – IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy

    Pierina Navarria & Marta Scorsetti

  7. Department of Neuroradiology, Humanitas Clinical and Research Center – IRCCS, Via A. Manzoni 56, Rozzano, 20089, Milan, Italy

    Marco Grimaldi & Letterio S. Politi

  8. Hematology & Oncology Division and Radiology Department, Boston Children’s Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA

    Letterio S. Politi

  9. Radiology Department and Advanced MRI Center, University of Massachusetts Medical School and Medical Center, 55 Lake Avenue N, Worcester, MA, 01655, USA

    Letterio S. Politi

Authors
  1. Riccardo Muglia
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  2. Matteo Simonelli
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  3. Federico Pessina
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  6. Pasquale Persico
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  7. Elena Lorenzi
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  8. Angelo Dipasquale
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  11. Armando Santoro
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  12. Letterio S. Politi
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Corresponding author

Correspondence to Letterio S. Politi.

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Guarantor

The scientific guarantor of this publication is Prof. Letterio S. Politi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Dr. Emanuela Morenghi kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was not required because of the retrospective nature of the study.

Methodology

• retrospective

• observational

• performed at one institution

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Supplementary information

Supplementary Fig. 1

X: TMT mean value of observer #1 measurements. Y: TMT mean value of observer #2 measurements. The units have to be intended in millimeters. (DOCX 92 kb)

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Muglia, R., Simonelli, M., Pessina, F. et al. Prognostic relevance of temporal muscle thickness as a marker of sarcopenia in patients with glioblastoma at diagnosis. Eur Radiol 31, 4079–4086 (2021). https://doi.org/10.1007/s00330-020-07471-8

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  • DOI: https://doi.org/10.1007/s00330-020-07471-8

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