A multicenter evaluation of the prognostic utility of changes in treatment-associated body composition in men with germ cell tumors (gct) of the testis: implications for adverse events and complications

You have accessJournal of UrologyCME1 Apr 2023MP50-14 A MULTICENTER EVALUATION OF THE PROGNOSTIC UTILITY OF CHANGES IN TREATMENT-ASSOCIATED BODY COMPOSITION IN MEN WITH GERM CELL TUMORS (GCT) OF THE TESTIS: IMPLICATIONS FOR ADVERSE EVENTS AND COMPLICATIONS Claire Buxton, Benjamin N. Schmeusser, Sarah K. Holt, Datta Patil, Anthea Phuong, J. Peter Marquardt, Ryan O'malley, Grace Laidlaw, George R. Schade, Daniel W. Lin, Michael T. Schweizer, Todd Yezefski, Evan Y. Yu, Bruce Montgomery, Florian J. Fintelmann, Sophia Chahine, Viraj A. Master, and Sarah P. Psutka Claire BuxtonClaire Buxton More articles by this author , Benjamin N. SchmeusserBenjamin N. Schmeusser More articles by this author , Sarah K. HoltSarah K. Holt More articles by this author , Datta PatilDatta Patil More articles by this author , Anthea PhuongAnthea Phuong More articles by this author , J. Peter MarquardtJ. Peter Marquardt More articles by this author , Ryan O'malleyRyan O'malley More articles by this author , Grace LaidlawGrace Laidlaw More articles by this author , George R. SchadeGeorge R. Schade More articles by this author , Daniel W. LinDaniel W. Lin More articles by this author , Michael T. SchweizerMichael T. Schweizer More articles by this author , Todd YezefskiTodd Yezefski More articles by this author , Evan Y. YuEvan Y. Yu More articles by this author , Bruce MontgomeryBruce Montgomery More articles by this author , Florian J. FintelmannFlorian J. Fintelmann More articles by this author , Sophia ChahineSophia Chahine More articles by this author , Viraj A. MasterViraj A. Master More articles by this author , and Sarah P. PsutkaSarah P. Psutka More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003298.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Skeletal muscle mass is associated with oncologic outcomes and treatment-associated toxicity across malignancies. However, men with GCT are younger and less likely to suffer baseline age-related muscle loss. As such, the prognostic utility of body composition metrics in GCT is undefined. We aimed to quantify changes in body composition following cytotoxic chemotherapy (CC) for GCT and evaluate associations between these changes and rates of CC-associated adverse events (AEs) and post-retroperitoneal lymphadenectomy (RPLND) complications. METHODS: This retrospective study included 216 patients with GCT (N=152 from Fred Hutchinson Cancer Center/ University of Washington; N=64 from Emory University Hospital) treated with CC and/or RPLND, with CT scans within 75 days before initiation and after completion of treatment. We analyzed L3 axial CT scans for skeletal muscle index (SMI), subcutaneous adipose index (SAI), and visceral adipose index (VAI). Logistic regression was used to evaluate associations between body composition metrics and grade 3+ AEs and Clavien 3+ post-RPLND complications. RESULTS: Median age for the cohort was 30 years (IQR 25-39) of whom, 47% of men had nonseminomatous GCT (Stage IS, II, and III in 17%, 39%, and 42%, respectively). 182 men received CC including BEP (67%), EP (19%), and VIP (7%), with a median of 3 cycles while 34 men (33%) and 69 men underwent primary and post-CC RPLND, respectively. Median time between CTs was 114 days. Median change in SMI, VAI, and SAI was -6% (Figure 1), +13%, and +11%, respectively. Overall, 79 men (43%) experienced grade 3+ AEs, and 24 men (23%) experienced Clavien 3+ post-RPLND complications. On regression analysis, higher baseline VAI (p=0.048), lower post-CC SMI (p=0.008), and decreased SMI (p=0.047) were associated with increased risk of grade 3+ AE. No baseline body composition metrics or changes therein during CC predicted risk of post-RPLND complications. CONCLUSIONS: We observed a decline in skeletal muscle and an increase in adipose tissue following CC in men with GCT. Both skeletal muscle and adipose tissue metrics were associated with the incidence of chemotherapy-associated adverse events and may have the potential for use in risk evaluation. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e690 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claire Buxton More articles by this author Benjamin N. Schmeusser More articles by this author Sarah K. Holt More articles by this author Datta Patil More articles by this author Anthea Phuong More articles by this author J. Peter Marquardt More articles by this author Ryan O'malley More articles by this author Grace Laidlaw More articles by this author George R. Schade More articles by this author Daniel W. Lin More articles by this author Michael T. Schweizer More articles by this author Todd Yezefski More articles by this author Evan Y. Yu More articles by this author Bruce Montgomery More articles by this author Florian J. Fintelmann More articles by this author Sophia Chahine More articles by this author Viraj A. Master More articles by this author Sarah P. Psutka More articles by this author Expand All Advertisement PDF downloadLoading ...