Sarcopenia as an independent prognostic marker in liposarcoma: A longitudinal analysis of body composition and survival.

Baseline sarcopenia was an independent predictor of mortality in liposarcoma patients in multivariate analysis.

• Hazard ratio for baseline sarcopenia was 2.331 (p = 0.007) in multivariate Cox regression analysis.
• The study included 64 patients from a retrospective, single-center study between 2010 and 2024.
• All patients underwent surgical tumor resection of a histologically confirmed liposarcoma.
• Survival data were obtained from the residents' registration office and analyzed using Kaplan-Meier survival analysis.

Progressive skeletal muscle index loss of 15% or greater was an independent predictor of mortality in liposarcoma patients.

• Hazard ratio for a ≥ 15% SMI decline was 2.601 (p = 0.006) in multivariate Cox regression analysis.
• SMI was measured on CT axial images at the height of lumbar vertebral 3 using standardized Hounsfield unit thresholds.
• This finding remained significant after adjustment in the multivariate model alongside baseline sarcopenia.

Significant reductions in multiple CT-derived body composition parameters were observed over the disease course of liposarcoma.

• Parameters showing significant reductions included skeletal muscle index (SMI), paraspinal muscle index (PSMI), psoas muscle index (PMI), and visceral adipose tissue (VAT).
• Skeletal muscle density (SMD) was also measured but was not listed among the significantly reduced parameters.
• Reductions were particularly notable among patients with high-grade tumors, chemotherapy, or local tumor recurrence.
• Metric data were compared using Student's t-test.

Tumor grade, chemotherapy, and local tumor recurrence influenced body composition changes in liposarcoma patients.

• Muscle loss was particularly pronounced among patients with high-grade tumors.
• Chemotherapy was associated with greater reductions in body composition parameters.
• Local tumor recurrence was also associated with more significant deterioration in CT-morphometric parameters.
• The study assessed the influence of tumor grade, recurrence, and treatment modalities on body composition as a secondary objective.

Neither baseline sarcopenia nor progressive SMI loss correlated with changes in Eastern Cooperative Oncology Group (ECOG) performance status.

• Baseline sarcopenia (HR: 2.331, p = 0.007) and ≥ 15% SMI decline (HR: 2.601, p = 0.006) were significant predictors of mortality but did not correlate with ECOG performance status changes.
• This dissociation suggests that CT-based body composition metrics capture prognostic information not reflected in functional status assessments.
• ECOG performance status is a standardized measure of functional status used in oncology settings.

The study used CT-derived morphometric parameters measured at the level of the third lumbar vertebra to assess body composition.

• Parameters measured included skeletal muscle index (SMI), paraspinal muscle index (PSMI), psoas muscle index (PMI), skeletal muscle density (SMD), and visceral adipose tissue (VAT).
• Standardized Hounsfield unit thresholds were used for the assessment of all parameters.
• Measurements were taken on CT axial images at the height of lumbar vertebral 3.
• Included patients had two consecutive CT scans available for longitudinal analysis.