Lower subcutaneous fat index predicts bone metastasis in breast cancer

Article type: Research Article

Authors: Wang, Wen^{a; 1} | Huang, Wen-Juan^{a; 1} | Liu, Ping-Ping^{a; 1} | Fu, Shuang^a | Zhang, Meng-Lin^a | Zhang, Xin^a | Wang, Rui-Tao^{a; *} | Huang, Yuan-Xi^{b; *}

Affiliations: [a] Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China | [b] Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China

Correspondence: [*] Corresponding authors: Rui-Tao Wang, Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang %****␣cbm-38-cbm230011_temp.tex␣Line␣125␣**** District, Harbin 150081, Heilongjiang, China. Tel.: +86 451 86298352; Fax: +86 451 86298353; E-mail: ruitaowang@126.com. Yuan-Xi Huang, Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin 150081, Heilongjiang, China. E-mail: rxwk@163.com.

Note: [1] Wen Wang, Wen-Juan Huang and Ping-Ping Liu contributed equally to this work and share first authorship.

Abstract: BACKGROUND: Bone metastases affect 50% to 70% of breast cancer (BC) patients and have a high mortality rate. Adipose tissue loss plays a pivotal role in the progression of cancer. OBJECTIVE: This study aims to evaluate the prognostic value of adipose tissue for bone metastasis in BC patients. METHODS: 517 BC patients were studied retrospectively. Patients’ characteristics before the surgery were collected. Quantitative measurements of the subcutaneous fat index (SFI) were performed at the level of the eleventh thoracic vertebra. In order to adjust for the heterogeneity between the low SFI and high SFI groups, propensity score matching (PSM) was used. The Kaplan-Meier method was used to estimate the 5-year bone metastatic incidence. The prognostic analysis was performed with the Cox regression models. RESULTS: Compared with the patients without bone metastasis, the patients with bone metastasis had reduced SFI levels. In addition, Kaplan-Meier analysis revealed that patients with low SFI were more likely to develop bone metastases. The independent predictive value of SFI for bone metastases was confirmed by Cox regression analysis. The survival analysis was repeated after PSM with a 1:1 ratio, yielding similar results (P< 0.05). CONCLUSIONS: SFI is an independent predictor of bone metastasis in BC patients.

Keywords: Breast cancer, bone metastasis, subcutaneous fat index, visceral fat index, propensity score analysis

DOI: 10.3233/CBM-230011

Journal: Cancer Biomarkers, vol. 38, no. 1, pp. 121-130, 2023