Sarcopenia—loss of skeletal muscle mass—can be quantified on routine computed tomography (CT) and has emerging prognostic relevance in oncology. This study compared three CT-based radiologic indices of sarcopenia in patients with metastatic castration-sensitive prostate cancer (mCSPC): the cross-sectional skeletal muscle index (SMI), the axial psoas muscle index (PMI), and a three-dimensional psoas muscle volume index (PVI). The primary aim was to evaluate and compare the associations of these indices with age, overall survival (OS), and prostate cancer–specific survival (PCSS).
Investigators performed a retrospective review of 120 patients diagnosed with mCSPC between 2003 and 2022. Baseline muscle parameters were calculated from diagnostic CT scans obtained at or before treatment. The study applied established and data-derived thresholds to define sarcopenia for each index and evaluated relationships of sarcopenia status with demographic variables and survival outcomes.
Sarcopenia was defined using the following criteria:
These thresholds were applied to classify patients as sarcopenic or non-sarcopenic for each index prior to survival analyses.
The analysis found age-related associations for two of the indices:
These findings indicate that older patients in this cohort were more likely to meet sarcopenia criteria by SMI and PVI, with PMI demonstrating a non-significant trend.
In univariable survival analyses, sarcopenia by each CT-derived index was associated with worse OS:
Each index identified a subgroup with substantially increased risk of death from any cause compared with non-sarcopenic patients in unadjusted models.
The abstract reports that none of the three sarcopenia indices showed significant impacts on PCSS in this cohort. Details of PCSS hazard ratios or p-values beyond the statement of non-significance were not provided in the source abstract.
After adjustment in multivariable models, each sarcopenia index remained an independent predictor of poorer overall survival:
These multivariable results indicate that, when using body-size–adjusted or statistically optimized thresholds, SMI, PMI, and PVI each contributed independent prognostic information for OS in patients with mCSPC in this dataset.
The authors conclude that all three CT-derived radiologic indices—SMI, PMI, and three-dimensional PVI—are easily and rapidly measurable and, when defined using body physique–adjusted or mathematically optimized thresholds, may serve as potential independent prognostic indicators for overall survival in patients with mCSPC. The study did not find significant associations between these indices and prostate cancer–specific survival in the abstract.
Clinically, these findings support consideration of CT-based muscle assessment as an adjunct prognostic metric in mCSPC. Specific implementation details, including integration with existing prognostic models or thresholds across populations, were not reported in the abstract and would require review of the full article for further methodological and contextual detail.
Note: This rewrite is based solely on information provided in the PubMed abstract. Additional methodological details, full statistical models, and subgroup analyses—if present in the full text—were not available in the source abstract and are not reported here.