Michael J Flores, Kelsey E Brown, Madeline C MacKechnie, Jamieson M O'Marr, Patricia Rodarte, David W Shearer
An Analysis of Participant Preferences Regarding Virtual Versus In-person Format of Orthopaedic Surgery Educational Materials in Low- and Middle-Income Countries
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
myosteatosis excess muscle fat infiltration novel prognostic factor cancer patients define myosteatosis skeletal muscle radiodensity smd commonly used intramuscular adipose tissue imat newly introduced aimed compare smddefined imatdefined myosteatosis predicting overall survival os patients advanced nonsmall cell lung cancer nsclc explore whether patients low smd high imat shorter os patients low smd high imat alone consecutively prospectively recruited adult patients stage iiib iv nsclc teaching hospital mean smd skeletal muscle areas area imat unenhanced chest computed tomography ct images 12th thoracic vertebral level segmented using mimics version 210 myosteatosis defined either low smd smddefined myosteatosis high imat imatdefined myosteatosis optimal cutoffs low smd high imat also determined using maximally selected rank statistics method calculated hazard ratios hrs corresponding confidence intervals cis evaluate associations os low smd high imat combination included 565 patients 345 men 220 women mean age 585 90 years lower imat exhibited tendency toward favorable prognosis men p 00015 women p 00001 whereas higher smd tended favorable prognosis men p 00006 women p 00001 baseline 423 749 participants high imat 432 765 participants low smd 370 655 participants high imat low smd compared without either high imat low smd participants either high imat low smd shorter os participants high imat low smd shortest os logrank p 00001 adjustment confounders high imat hr 144 95 ci 110187 low smd hr 192 95 ci 136243 separately associated poor prognosis moreover combination high imat low smd indicated higher risk poor prognosis hr 243 95 ci 162366 smddefined imatdefined myosteatosis highly prevalent patients advanced nsclc may serve independent prognostic factors os diagnosis myosteatosis might consider combination low smd high imat would help identify patients higher risk mortality