Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Measurement of Imaging Parameters
2.3. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Adipose Tissue Measurement
3.3. Recurrence-Free Survival
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics | Number (%) | Median (Range) |
---|---|---|
Age (years) | 51 (30–85) | |
Body mass index | 23.7 (16.4–35.2) | |
Obesity | ||
Underweight/normal | 145 (43.2%) | |
Overweight/obese | 191 (56.8%) | |
Menopausal status | ||
Premenopausal | 143 (42.6%) | |
Postmenopausal | 193 (57.4%) | |
Histopathology | ||
Intraductal carcinoma | 299 (89.0%) | |
Intralobular carcinoma | 37 (11.0%) | |
T stage | ||
T1 | 154 (45.8%) | |
T2 | 147 (43.7%) | |
T3 | 23 (6.8%) | |
T4 | 12 (3.6%) | |
N stage | ||
N0 | 216 (64.3%) | |
N1 | 69 (20.5%) | |
N2 | 29 (8.6%) | |
N3 | 22 (6.5%) | |
Histologic grade | ||
Grade 1 | 83 (24.7%) | |
Grade 2 | 169 (50.3%) | |
Grade 3 | 84 (25.0%) | |
Estrogen receptor status | ||
Positive | 250 (74.4%) | |
Negative | 86 (25.6%) | |
Progesterone receptor status | ||
Positive | 208 (61.9%) | |
Negative | 128 (38.1%) | |
HER2 status | ||
Positive | 169 (50.3%) | |
Negative | 167 (49.7%) | |
Ki67 expression status | ||
Positive | 221 (65.8%) | |
Negative | 115 (34.2%) | |
Maximum FDG uptake | 4.05 (1.10–37.90) | |
VAT volume (cm3) | 22.1 (5.6–95.0) | |
VAT CT-attenuation (HU) | −96.3 (−112.8–−76.9) | |
Abdominal SAT volume (cm3) | 85.0 (6.8–212.2) | |
Abdominal SAT CT-attenuation (HU) | −102.0 (−114.9–−79.6) | |
Gluteofemoral AT volume (cm3) | 93.3 (30.4–191.1) | |
Gluteofemoral AT CT-attenuation (HU) | −97.5 (−108.7–−82.5) | |
AG volume ratio | 1.15 (0.40–5.08) | |
Neoadjuvant chemotherapy | ||
Yes | 46 (13.7%) | |
No | 290 (86.3%) | |
Adjuvant treatment | ||
CTx + RTx + HTx | 162 (48.2%) | |
RTx + HTx | 97 (28.9%) | |
CTx + HTx | 19 (5.7%) | |
CTx + RTx | 5 (1.5%) | |
HTx | 27 (8.0%) | |
CTx | 19 (5.7%) | |
RTx | 3 (0.9%) | |
No | 4 (1.2%) |
Variables | p-Value | Hazard Ratio (95% CI) |
---|---|---|
Age (1-year increase) | 0.534 | 1.01 (0.98–1.04) |
Obesity (underweight/normal vs. overweight/obese) | 0.717 | 1.13 (0.58–2.18) |
Menopausal status (pre vs. post) | 0.975 | 0.99 (0.51–1.92) |
T stage | ||
T1 stage | – | 1.00 |
T2 stage | <0.001 | 8.55 (2.56–28.56) |
T3 stage | <0.001 | 22.71 (6.32–81.68) |
N stage (N0 vs. N1–3) | 0.005 | 2.55 (1.32–4.93) |
Histologic grade | ||
Grade 1 | – | 1.00 |
Grade 2 | 0.361 | 0.59 (0.19–1.82) |
Grade 3 | 0.001 | 3.23 (1.59–6.54) |
ER status (positive vs. negative) | <0.001 | 3.76 (1.95–7.25) |
PR status (positive vs. negative) | <0.001 | 4.87 (2.34–10.10) |
HER2 status (positive vs. negative) | 0.540 | 0.81 (0.42–1.57) |
Ki67 index (negative vs. positive) | 0.003 | 6.07 (1.86–19.78) |
Triple negative tumor (no vs. yes) | <0.001 | 3.54 (1.70–7.36) |
Maximum FDG uptake (1.0 increase) | 0.001 | 1.07 (1.03–1.11) |
VAT volume (1.0 cm3 increase) | 0.732 | 1.00 (0.99–1.02) |
VAT CT-attenuation (1.0 HU increase) | 0.920 | 1.00 (0.95–1.06) |
Abdominal SAT volume (1.0 cm3 increase) | 0.006 | 1.01 (1.00–1.02) |
Abdominal SAT CT-attenuation (1.0 HU increase) | 0.273 | 1.04 (0.97–1.12) |
Gluteofemoral AT volume (1.0 cm3 increase) | <0.001 | 0.97 (0.96–0.99) |
Gluteofemoral AT CT-attenuation (1.0 HU increase) | 0.135 | 1.07 (0.98–1.17) |
AG volume ratio (1.0 increase) | <0.001 | 2.40 (1.74–3.29) |
Variables | Model with Abdominal SAT Volume | Model with Gluteofemoral AT Volume | Model with AG Volume Ratio | |||
---|---|---|---|---|---|---|
p-Value | Hazard Ratio (95% CI) | p-Value | Hazard Ratio (95% CI) | p-Value | Hazard Ratio (95% CI) | |
T stage | ||||||
T2 | 0.003 | 6.46 (1.91–21.79) | 0.002 | 6.82 (2.02–23.07) | 0.005 | 5.92 (1.74–20.20) |
T3–4 | <0.001 | 18.26 (4.95–67.36) | <0.001 | 15.39 (4.11–57.66) | <0.001 | 16.04 (4.22–61.05) |
N stage | 0.913 | 1.04 (0.50–2.19) | 0.720 | 1.15 (0.54–2.42) | 0.834 | 0.92 (0.44–1.95) |
Histologic grade | ||||||
Grade 2 | 0.243 | 2.01 (0.62–6.50) | 0.516 | 1.46 (0.54–2.42) | 0.076 | 3.41 (0.88–13.25) |
Grade 3 | 0.120 | 2.59 (0.79–8.45) | 0.180 | 1.68 (0.79–3.59) | 0.027 | 4.95 (1.20–20.47) |
Estrogen receptor | <0.001 | 3.65 (1.75–7.63) | 0.010 | 2.92 (1.29–6.63) | 0.043 | 2.41 (1.03–5.66) |
Progesterone receptor | 0.094 | 2.53 (0.85–7.51) | 0.048 | 2.85 (1.01–8.07) | 0.293 | 1.87 (0.58–6.03) |
Ki67 index | 0.306 | 1.95 (0.54–7.03) | 0.270 | 2.07 (0.57–7.50) | 0.435 | 1.67 (0.46–6.09) |
Triple negative tumor status | 0.547 | 1.34 (0.52–3.47) | 0.822 | 0.894 (0.34–2.38) | 0.756 | 1.16 (0.46–2.93) |
Maximum FDG uptake | 0.600 | 0.98 (0.93–1.05) | 0.483 | 0.98 (0.92–1.04) | 0.586 | 0.98 (0.92–1.05) |
Abdominal SAT volume | 0.002 | 1.02 (1.01–1.03) | ||||
Gluteofemoral AT volume | <0.001 | 0.98 (0.96–0.99) | ||||
AG volume ratio | <0.001 | 2.50 (1.64–3.81) |
BMI | |||
---|---|---|---|
Underweight/Normal (BMI < 23.0 kg/m2) | Overweight/Obesity (BMI > 23.0 kg/m2) | ||
AG volume ratio | <1.50 | 10/127 (7.9%) | 9/132 (6.8%) |
>1.50 | 6/18 (33.3%) | 11/59 (18.6%) | |
p-value | 0.001 | 0.014 |
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Lee, J.W.; Kim, S.Y.; Lee, H.J.; Han, S.W.; Lee, J.E.; Lee, S.M. Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer. J. Clin. Med. 2019, 8, 1358. https://doi.org/10.3390/jcm8091358
Lee JW, Kim SY, Lee HJ, Han SW, Lee JE, Lee SM. Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer. Journal of Clinical Medicine. 2019; 8(9):1358. https://doi.org/10.3390/jcm8091358
Chicago/Turabian StyleLee, Jeong Won, Sung Yong Kim, Hyun Ju Lee, Sun Wook Han, Jong Eun Lee, and Sang Mi Lee. 2019. "Prognostic Significance of Abdominal-to-Gluteofemoral Adipose Tissue Distribution in Patients with Breast Cancer" Journal of Clinical Medicine 8, no. 9: 1358. https://doi.org/10.3390/jcm8091358