TY  - JOUR
AU  - Berclaz, Luc M
AU  - Di Gioia, Dorit
AU  - Völkl, Michael
AU  - Jurinovic, Vindi
AU  - Klein, Alexander
AU  - Dürr, Hans Roland
AU  - Knösel, Thomas
AU  - Teodorescu, Bianca
AU  - Enßle, Stefan
AU  - Rippl, Michaela
AU  - von Bergwelt-Baildon, Michael
AU  - Kunz, Wolfgang G
AU  - Lindner, Lars H
AU  - Burkhard-Meier, Anton
TI  - The impact of CT-based adipose tissue distribution and sarcopenia on treatment outcomes in patients with high-risk soft tissue sarcoma.
JO  - BMC cancer
VL  - 25
IS  - 1
SN  - 1471-2407
CY  - London
PB  - BioMed Central
M1  - DKFZ-2025-00779
SP  - 671
PY  - 2025
AB  - The prognostic and predictive value of obesity and sarcopenia remains poorly defined in patients with high-risk soft tissue sarcoma (HR-STS). We sought to correlate clinical outcomes with CT-based body composition parameters in patients with HR-STS undergoing a multimodal preoperative therapy. The impact of radiologic and histopathologic response to preoperative treatment was correlated with individual fat and muscle distribution.Patients with locally advanced non-abdominal HR-STS and treatment with preoperative chemotherapy + regional hyperthermia (RHT) +/- radiotherapy (RT) followed by surgery between 2015 and 2022 were retrospectively evaluated. Body composition parameters measured on baseline CT scans were correlated with clinical outcomes including event-free survival (EFS) and overall survival (OS) as well as radiologic and histopathologic treatment response.A total of 85 patients were included. Body composition parameters showed no significant correlation with radiologic or histopathologic treatment response. High total fat indices such as the total fat index (TFI, HR 3.56, p = 0.005) and high total fat to muscle ratio (FMR, HR 3.22, p = 0.020) were strongly associated with poor OS. Parameters for sarcopenia including skeletal muscle index (SMI) were not significantly linked to survival outcomes.High fat indices and a high FMR are strong predictors of poor OS in patients with HR-STS. Larger studies are warranted to further clarify the prognostic impact of sarcopenia and the predictive value of body composition parameters on preoperative treatment response.
KW  - Humans
KW  - Sarcopenia: diagnostic imaging
KW  - Male
KW  - Female
KW  - Middle Aged
KW  - Sarcoma: therapy
KW  - Sarcoma: mortality
KW  - Sarcoma: pathology
KW  - Sarcoma: diagnostic imaging
KW  - Sarcoma: complications
KW  - Tomography, X-Ray Computed: methods
KW  - Aged
KW  - Retrospective Studies
KW  - Adult
KW  - Adipose Tissue: diagnostic imaging
KW  - Adipose Tissue: pathology
KW  - Prognosis
KW  - Treatment Outcome
KW  - Body Composition
KW  - Young Adult
KW  - Combined Modality Therapy
KW  - Chemotherapy (Other)
KW  - EORTC-STBSG (Other)
KW  - Fat to muscle ratio (Other)
KW  - RECIST (Other)
KW  - Regional hyperthermia (Other)
KW  - Skeletal muscle index (Other)
KW  - Soft tissue sarcoma (Other)
KW  - Total fat index (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:40217461
C2  - pmc:PMC11992814
DO  - DOI:10.1186/s12885-025-14050-x
UR  - https://inrepo02.dkfz.de/record/300345
ER  -