P369 - MUSCLE MASS AND ADIPOSITY MEASURED BY COMPUTED TOMOGRAPHY PREDICT PROGNOSIS IN ADVANCED BILIARY TRACT CANCER PATIENTS

P369

MUSCLE MASS AND ADIPOSITY MEASURED BY COMPUTED TOMOGRAPHY PREDICT PROGNOSIS IN ADVANCED BILIARY TRACT CANCER PATIENTS

S. E. Oh^1,*, S. U. HAN¹, S. LEE ², J. H. KIM ², H.-C. JEUNG ²

¹Division of Oncology, Department of Medicine, Yonsei University College of Medicine., ²Division of Oncology, Department of Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, Republic Of

Rationale: Biliary tract cancer (BTC) is a highly lethal disease. Sarcopenia, poor muscle quality (low muscle attenuation) and excess adiposity (subcutaneous and visceral) are markers of frailty. We evaluated associations of these body composition markers, assessed from abdomino-pelvic CT at diagnosis, with overall survival (OS) in advanced BTC patients.

Methods: A cohort comprised of BTC patients between September 2006 and January 2020. We defined L3 muscle index (L3MI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI) and Hounsfield Unit (HU) at the level of the L3 vertebra. Clinical data were extracted from patients’ charts. Variables that had potential associations with muscle wasting were plotted into logistic regressions. Kaplan-Meier analysis and the Cox proportional hazard model were done. Muscle wasting was defined as low L3MI acquired by CT, cut-off point of which was following international cut-off which is <55 cm^2/m^2 for men and <39 cm^2/m^2 for women.

Results: A total of 1078 patients (54.7% males) were included. Patients with low L3MI (n=854) had a tendency of lower SATI (36.3 ± 23.5 vs 56.4 ± 27.2 cm^2/m^2, p<0.001) and lower VATI (31.9 ± 22.5 vs 40.0 ± 21.9 cm^2/m^2, p<0.001). Combining with four body composition factors (L3M1, SATI, VATI, and HU), we found that low-risk group (n=379) had the best OS (median 12.5 months, 95% CI, 11.4-13.6), while those who had all the risk factors (n=35) showed the poorest OS (median 4.9 months, 95% CI, 2.6-7.2, p<0.001). In multivariate analysis, combined all risk was included as an independent prognosticator (HR 1.870, 95% CI 1.313-2.665, P=0.001) along with neutrophil-to-lymphocyte ratio, CEA and CRP

Conclusion: Body composition data on diagnosis can predict survival in advanced BTC patients and can be utilized as surrogate markers for prognosis.

Disclosure of Interest: None declared