CT attenuation and cross-sectional-area index of the pectoralis are associated with prognosis in sarcoma patients

Background/Aim: To identify prognostic imaging biomarkers from staging chest computed tomography (CT) in patients with sarcomas. Patients and Methods: CT scans for baseline staging, and surveillance 1-year CT scans in patients newly diagnosed with sarcoma were evaluated. Pectoralis muscle area (PMA), pectoralis muscle index (PMI) and pectoralis CT attenuation density (PMT) were measured. Cox proportional-hazard models were used to determine the association with progression-free survival (PFS) and overall survival (OS). Results: There were 147 patients (53.1% male) who were followed for a median 1,414 days (range=219-4851 days). Approximately 47.6% (70/147) of patients progressed and 29.9% (44/147) died. Multivariable Cox-proportional hazards models adjusting for gender, tumor grade and chemotherapy treatment showed that a higher baseline PMT and baseline PMI were associated with increased OS. Conclusion: Higher baseline PMI and PMT are associated with increased overall survival in patients with sarcoma.