Associations between CT-Based Body Composition and Cardiotoxicity and Overall Survival in Patients with Prostate...

The purpose of this study was to investigate the associations of parameters of computed tomography (CT)-based body composition with cancer treatment-related cardiac dysfunction (CTRCD) and with overall survival (OS) in patients with prostate cancer who received androgen deprivation therapy (ADT).

Patients with prostate cancer treated with ADT were retrospectively included. Parameters of CT-based body composition, including the area and density of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and skeletal muscle (SM), were measured on axial images at the third lumbar vertebra. The associations between body composition and CTRCD were assessed by logistic regression analysis. The associations between body composition and OS were assessed using Cox regression analysis.

Among the 530 patients enrolled, 45 developed CTRCD, and 198 died during a median follow-up of 45 months (interquartile range, 23-54 months). Patients with CTRCD had a significantly lower SM index than patients without CTRCD (29.16 ± 3.66 vs. 38.3 ± 3.83 cm²/m², respectively, P < 0.001). A lower SM index was associated with a significantly increased risk of CTRCD (odds ratio = 1.965, 95% CI: 1.459-3.472, P = 0.005) and a poor OS (hazard ratio = 2.201, 95% CI: 1.817-2.766, P = 0.008).

Utilization of the CT-based SM index contributes to the baseline risk stratification of cardiotoxicity and OS in patients with prostate cancer treated with ADT.