AB028. SOH24AB_086. Evaluating the impact of sarcopenia on oncological and survival outcomes in patients with locally advanced breast cancer
Clinical Breast Session

AB028. SOH24AB_086. Evaluating the impact of sarcopenia on oncological and survival outcomes in patients with locally advanced breast cancer

Thomas Butler1, Jessie Elliott1, Matthew Davey1, Patrick Collins2, Micheal Brennan2, Michael Barry2, Sami Abd El Wahab2, Karl Sweeney2, Carmel Malone2, Ray McLaughlin2, Aoife Lowery1,2, Michael Kerin1,2

1Lambe Institute for Translational Research, Department of Surgery, University of Galway, Galway, Ireland; 2Department of Surgery, University Hospital Galway, Galway, Ireland

Background: Sarcopenia has been associated with negative clinical outcomes in several cancers, however its prevalence and impact on outcomes in patients being treated for locally advanced breast cancer (LABC) are yet to be determined. We assessed the impact of sarcopenia on outcomes in LABC.

Methods: Consecutive female patients with LABC indicated to undergo neoadjuvant therapy (NAT) and surgery between 2010–2015 were included. Skeletal muscle index (SMI) and lean body mass (LBM) were determined. Sarcopenia was defined using computed tomography (CT) at L3 as SMI <38.5 cm2/m2. Thereafter, multivariable linear, logistic, and Cox regression analysis was undertaken to determine the independent impact of sarcopenia on outcomes.

Results: Among 258 patients, the prevalence of sarcopenia was 23.0%, 7.8% and 0.0% of patients with normal weight, overweight and obesity, respectively (P=0.001). Sarcopenia was not associated with cT and cN stage, tumour grade, histologic type or receptor status. Moreover, sarcopenia was not associated with tumour sensitivity to NAT (i.e., ypT and ypN stage, pathologic complete response, and Sataloff grade). Postoperatively, sarcopenia did not independently predict with comprehensive complications index (P=0.242), length of stay (P=0.716) or overall morbidity (P=0.365). However, on multivariable analysis, lower LBM independently predicted reduced invasive disease-free survival (iDFS) [hazard ratio (HR): 0.93, 95% confidence interval (CI): 0.87–1.00, P=0.049] and overall survival (OS) (HR: 0.92, 95% CI: 0.85–0.99, P=0.028), but not disease-specific survival (DSS) (P=0.070).

Conclusions: Sarcopenia was not associated with clinicopathological parameters or tumour response to NAT, however, reduced LBM independently predicted OS, but not DSS, in LABC. These data suggest that the prognostic impact of sarcopenia may be largely mediated by impaired performance status and increased non-cancer mortality.

Keywords: Locally advanced breast cancer (LABC); neoadjuvant therapy (NAT); prognostic outcomes; sarcopenia; survival outcomes

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab028
Cite this abstract as: Butler T, Elliott J, Davey M, Collins P, Brennan M, Barry M, Abd El Wahab S, Sweeney K, Malone C, McLaughlin R, Lowery A, Kerin M. AB028. SOH24AB_086. Evaluating the impact of sarcopenia on oncological and survival outcomes in patients with locally advanced breast cancer. Mesentery Peritoneum 2024;8:AB028.

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