---
title: "CT-Based Sarcopenia Indices (SMI, PMI, PVI) and Prognosis in Metastatic Castration-Sensitive Prost"
id: "pubmed-42670789"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42670789"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42670789/"
doi: "10.1111/iju.70627"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# CT-Based Sarcopenia Indices (SMI, PMI, PVI) and Prognosis in Metastatic Castration-Sensitive Prost
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42670789
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42670789/)
- **DOI:** [10.1111/iju.70627](https://doi.org/10.1111%2Fiju.70627)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Objective: Compare prognostic value of three CT-based sarcopenia indices—**skeletal muscle index (SMI)**, **psoas muscle index (PMI)**, and three-dimensional psoas volume index (**PVI**)—in patients with metastatic castration-sensitive prostate cancer (mCSPC). - Design: Retrospective review of 120 patients with mCSPC diagnosed between 2003 and 2022; baseline muscle measures calculated from diagnostic CT scans. - Definitions and cut-offs: Sarcopenia by SMI used the Martin criteria; optimal cut-offs derived from maximally selected rank statistics were PMI = 4.08 cm2/m2 and PVI = 92 cm3/m2. - Associations tested: Relationships of each index with age, overall survival (**OS**), and prostate cancer-specific survival (**PCSS**) were evaluated. - Age associations: Increasing age was significantly associated with SMI-defined sarcopenia (OR 1.05, p = 0.036) and PVI-defined sarcopenia (OR 1.09, p < 0.001); PMI showed a non-significant trend (OR 1.06, p = 0.069). - Survival findings (univariable): Sarcopenia by all three indices correlated with worse **OS** (SMI HR 1.88, p = 0.032; PMI HR 2.19, p = 0.016; PVI HR 2.07, p = 0.013). - Multivariable results: Each index remained an independent predictor of poorer OS (SMI HR 1.86, p = 0.042; PMI HR 3.73, p < 0.001; PVI HR 2.46, p = 0.006). - PCSS: No significant associations between these sarcopenia indices and **PCSS** were observed in this cohort. - Conclusion: Using body-size–adjusted or statistically optimized thresholds, rapidly measurable CT-derived indices (SMI, PMI, PVI) may serve as independent prognostic indicators for OS in patients with mCSPC. - Practical note: All reported findings and numeric values are taken from the study abstract; further methodological and contextual details were not reported in the source abstract provided.
## Clinical Analysis & Structured Key Points
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Comparative Prognostic Impact of Two-Dimensional and Three-Dimensional Computed Tomography-Based Sarcopenia Indices in Metastatic Castration-Sensitive Prostate Cancer [Tomohiro Hori](https://pubmed.ncbi.nlm.nih.gov/?term=Hori+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroaki Iwamoto](https://pubmed.ncbi.nlm.nih.gov/?term=Iwamoto+H&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Takahiro Inaba](https://pubmed.ncbi.nlm.nih.gov/?term=Inaba+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Ryunosuke Nakagawa](https://pubmed.ncbi.nlm.nih.gov/?term=Nakagawa+R&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Taiki Kamijima](https://pubmed.ncbi.nlm.nih.gov/?term=Kamijima+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroshi Kano](https://pubmed.ncbi.nlm.nih.gov/?term=Kano+H&cauthor_id=42670789)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-2 "Department of Urology, Komatsu Municipal Hospital, Komatsu, Japan."), [Tomoyuki Makino](https://pubmed.ncbi.nlm.nih.gov/?term=Makino+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Renato Naito](https://pubmed.ncbi.nlm.nih.gov/?term=Naito+R&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Suguru Kadomoto](https://pubmed.ncbi.nlm.nih.gov/?term=Kadomoto+S&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroshi Yaegashi](https://pubmed.ncbi.nlm.nih.gov/?term=Yaegashi+H&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Kazuyoshi Shigehara](https://pubmed.ncbi.nlm.nih.gov/?term=Shigehara+K&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Takahiro Nohara](https://pubmed.ncbi.nlm.nih.gov/?term=Nohara+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Kouji Izumi](https://pubmed.ncbi.nlm.nih.gov/?term=Izumi+K&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Atsushi Mizokami](https://pubmed.ncbi.nlm.nih.gov/?term=Mizokami+A&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#full-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.") Affiliations Expand ### Affiliations * 1 Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. * 2 Department of Urology, Komatsu Municipal Hospital, Komatsu, Japan. * PMID: **42670789** * DOI: [ 10.1111/iju.70627 ](https://doi.org/10.1111/iju.70627) Item in Clipboard Comparative Study # Comparative Prognostic Impact of Two-Dimensional and Three-Dimensional Computed Tomography-Based Sarcopenia Indices in Metastatic Castration-Sensitive Prostate Cancer Tomohiro Hori et al. Int J Urol. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Int J Urol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Int+J+Urol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Int+J+Urol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42670789/) . 2026 Sep;33(9):e70627. doi: 10.1111/iju.70627. ### Authors [Tomohiro Hori](https://pubmed.ncbi.nlm.nih.gov/?term=Hori+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroaki Iwamoto](https://pubmed.ncbi.nlm.nih.gov/?term=Iwamoto+H&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Takahiro Inaba](https://pubmed.ncbi.nlm.nih.gov/?term=Inaba+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Ryunosuke Nakagawa](https://pubmed.ncbi.nlm.nih.gov/?term=Nakagawa+R&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Taiki Kamijima](https://pubmed.ncbi.nlm.nih.gov/?term=Kamijima+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroshi Kano](https://pubmed.ncbi.nlm.nih.gov/?term=Kano+H&cauthor_id=42670789)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-2 "Department of Urology, Komatsu Municipal Hospital, Komatsu, Japan."), [Tomoyuki Makino](https://pubmed.ncbi.nlm.nih.gov/?term=Makino+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Renato Naito](https://pubmed.ncbi.nlm.nih.gov/?term=Naito+R&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Suguru Kadomoto](https://pubmed.ncbi.nlm.nih.gov/?term=Kadomoto+S&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Hiroshi Yaegashi](https://pubmed.ncbi.nlm.nih.gov/?term=Yaegashi+H&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Kazuyoshi Shigehara](https://pubmed.ncbi.nlm.nih.gov/?term=Shigehara+K&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Takahiro Nohara](https://pubmed.ncbi.nlm.nih.gov/?term=Nohara+T&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Kouji Izumi](https://pubmed.ncbi.nlm.nih.gov/?term=Izumi+K&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan."), [Atsushi Mizokami](https://pubmed.ncbi.nlm.nih.gov/?term=Mizokami+A&cauthor_id=42670789)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42670789/#short-view-affiliation-1 "Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.") ### Affiliations * 1 Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. * 2 Department of Urology, Komatsu Municipal Hospital, Komatsu, Japan. * PMID: **42670789** * DOI: [ 10.1111/iju.70627 ](https://doi.org/10.1111/iju.70627) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objectives:** This study evaluated and compared the prognostic significance of three different computed tomography (CT)-based radiological indices of sarcopenia-skeletal muscle index (SMI), psoas muscle index (PMI), and three-dimensional (3D) psoas muscle volume index (PVI)-in patients with metastatic castration-sensitive prostate cancer (mCSPC). **Methods:** We retrospectively reviewed 120 patients diagnosed with mCSPC (2003-2022). Baseline muscle parameters were calculated from diagnostic CT scans. Sarcopenia was defined using the Martin criteria for SMI, and optimal cut-offs derived from maximally selected rank statistics for PMI (4.08 cm2/m2) and PVI (92 cm3/m2). Associations of these indices with age, overall survival (OS), and prostate cancer-specific survival (PCSS) were evaluated. **Results:** Advancing age was significantly associated with SMI (OR: 1.05, p = 0.036) and PVI-defined sarcopenia (OR: 1.09, p < 0.001), with a non-significant trend for PMI (OR: 1.06, p = 0.069). Survival analysis revealed that sarcopenia by all three indices was significantly associated with worse OS (SMI [HR: 1.88, p = 0.032], PMI [HR: 2.19, p = 0.016], and PVI [HR: 2.07, p = 0.013]). In multivariable analyzes, SMI (HR: 1.86, p = 0.042), PMI (HR: 3.73, p < 0.001), and PVI (HR: 2.46, p = 0.006) remained independent risk factors for poorer OS. No significant impacts were observed for PCSS. **Conclusions:** When using body physique-adjusted or mathematically optimized thresholds, all three easily and rapidly measurable radiological indices (SMI, PMI, and PVI) may serve as potential, independent prognostic indicators for OS in patients with mCSPC. **Keywords:** X‐ray computed tomography; prognosis; prostatic neoplasms; sarcopenia; survival analysis. © 2026 The Japanese Urological Association. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Association of magnetic resonance imaging-derived sarcopenia with outcomes of patients with hepatocellular carcinoma after hepatectomy. ](https://pubmed.ncbi.nlm.nih.gov/38900325/) Rao C, Chen J, Xu K, Xue C, Wu L, Huang X, Chen S, Rao S, Li F.Rao C, et al.Abdom Radiol (NY). 2024 Jul;49(7):2272-2284. doi: 10.1007/s00261-024-04439-w. Epub 2024 Jun 20.Abdom Radiol (NY). 2024.PMID: 38900325 * [ The prognostic role of sarcopenia and muscle wasting in adult osteosarcoma patients: A longitudinal CT morphometric analysis. ](https://pubmed.ncbi.nlm.nih.gov/40627918/) Kylies J, Ballhause TM, Striefler J, Kylies D, Priemel M.Kylies J, et al.Eur J Surg Oncol. 2025 Sep;51(9):110293. doi: 10.1016/j.ejso.2025.110293. Epub 2025 Jun 28.Eur J Surg Oncol. 2025.PMID: 40627918 * [ Poor performance of psoas muscle index for identification of patients with higher waitlist mortality risk in cirrhosis. ](https://pubmed.ncbi.nlm.nih.gov/30269421/) Ebadi M, Wang CW, Lai JC, Dasarathy S, Kappus MR, Dunn MA, Carey EJ, Montano-Loza AJ; From the Fitness, Life Enhancement, and Exercise in Liver Transplantation (FLEXIT) Consortium.Ebadi M, et al.J Cachexia Sarcopenia Muscle. 2018 Dec;9(6):1053-1062. doi: 10.1002/jcsm.12349. Epub 2018 Sep 29.J Cachexia Sarcopenia Muscle. 2018.PMID: 30269421Free PMC article. * [ Prognostic Significance of Myopenia, Myosteatosis, and Frailty in Older Patients With Prostate Cancer Undergoing Definitive Radiotherapy. ](https://pubmed.ncbi.nlm.nih.gov/42013016/) Aksoy RA, Koca T, Çetmi DA, Kızılkaya M, Korcum AF.Aksoy RA, et al.Cancer Control. 2026 Jan-Dec;33:10732748261446040. doi: 10.1177/10732748261446040. Epub 2026 Apr 21.Cancer Control. 2026.PMID: 42013016Free PMC article. * [ Sarcopenia and ovarian cancer survival: a systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/31389674/) Ubachs J, Ziemons J, Minis-Rutten IJG, Kruitwagen RFPM, Kleijnen J, Lambrechts S, Olde Damink SWM, Rensen SS, Van Gorp T.Ubachs J, et al.J Cachexia Sarcopenia Muscle. 2019 Dec;10(6):1165-1174. doi: 10.1002/jcsm.12468. Epub 2019 Aug 7.J Cachexia Sarcopenia Muscle. 2019.PMID: 31389674Free PMC article. [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42670789) ## References 1. 1. R. L. Siegel, T. B. Kratzer, N. S. Wagle, H. Sung, and A. Jemal, “Cancer Statistics, 2026,” CA: A Cancer Journal for Clinicians 76 (2026): e70043. 2. 1. H. Miyake, R. Matsumoto, K. Fujimoto, et al., “Clinical Outcomes of Patients W
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