Purpose: Temporal muscle thickness (TMT) has been proposed as a novel surrogate marker for skeletal muscle mass in head and neck malignancies. This study investigated the TMT prognostic relevance with gliomas and evaluated the influence of TMT values on survival in patients with gliomas of different grades and IDH subtypes.
Methods: The patients’ TMT was measured on contrast-enhanced T1-weighted magnetic resonance images before surgical treatment. Patients were divided into two cohorts based on their median TMT values. The Kaplan–Meier curve was used to compute the overall survival (OS) of different categories and all gliomas. Univariate and multivariate Cox regression analyses were conducted to assess the association between OS and TMT, hematological markers, and other clinical factors in glioma patients. Moreover, the clinical diagnostic efficiency of single and combination biomarkers was evaluated using receiver operating characteristic curve analysis.
Results: We retrospectively analyzed 261 patients with newly diagnosed glioma between November 2016 and May 2020 at Hunan Cancer Hospital. Cox analysis indicated that higher TMT (HR 0.286, P< 0.001) and higher KPS score (HR 0.629, P= 0.012) were protective prognostic factors and IDH wildtype status (HR 2.946, P< 0.001), RDW > 12.6 (HR 1.513, P= 0.036), and NLR > 4 (HR 1.560, P= 0.042) were poor prognostic factors for gliomas. Subsequently, patients with thicker TMT were found to have significantly better overall survival (P< 0.001) than patients with thinner TMT among WHO III and WHO IV grade and patients with or without IDH mutation. TMT was considered a better single biomarker than recently prevalent hematological biomarkers for predicting high-grade [0.856 (0.797– 0.916)] and IDH- wild-type [0.864 (0.786– 0.941)] gliomas.
Conclusion: This study suggests that TMT is a positive biomarker for clinical prognosis in gliomas and that patients with thicker TMT have greater overall survival for gliomas of different grades and IDH subtypes.

Keywords: gliomas, temporal muscle thickness, IDH status, overall survival, prognostic biomarkers


中文翻译：

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颞肌厚度是胶质瘤患者的独立预后生物标志物：261 例病例分析

目的：颞肌厚度 (TMT) 已被提议作为头颈部恶性肿瘤骨骼肌质量的新替代指标。本研究调查了 TMT 与胶质瘤的预后相关性，并评估了 TMT 值对不同级别和 IDH 亚型胶质瘤患者生存的影响。
方法：在手术治疗前，通过对比增强 T1 加权磁共振图像测量患者的 TMT。根据他们的中位 TMT 值将患者分为两组。Kaplan-Meier 曲线用于计算不同类别和所有神经胶质瘤的总生存期 (OS)。进行单变量和多变量 Cox 回归分析以评估胶质瘤患者 OS 与 TMT、血液学标志物和其他临床因素之间的关联。此外，使用受试者工作特征曲线分析评估单一和组合生物标志物的临床诊断效率。
结果：我们回顾性分析了 2016 年 11 月至 2020 年 5 月在湖南省肿瘤医院新诊断的 261 例胶质瘤患者。Cox 分析表明，较高的 TMT（HR 0.286，P<0.001）和较高的 KPS 评分（HR 0.629，P=0.012）是保护性预后因素和 IDH 野生型状态（HR 2.946，P<0.001），RDW > 12.6（HR 1.513， P = 0.036）和 NLR > 4（HR 1.560，P = 0.042）是胶质瘤的不良预后因素。随后，在 WHO III 和 WHO IV 级以及有或没有 IDH 突变的患者中，发现 TMT 较厚的患者总生存期明显优于 TMT 较薄的患者（P<0.001）。TMT 被认为是比最近流行的血液学生物标志物更好的单一生物标志物，用于预测高级别 [0.856 (0.797–0.916)] 和 IDH- 野生型 [0.864 (0.786– 0.941)] 胶质瘤。
结论：本研究表明，TMT 是胶质瘤临床预后的阳性生物标志物，TMT 较厚的患者在不同级别和 IDH 亚型的胶质瘤中总生存率更高。

关键词：胶质瘤，颞肌厚度，IDH状态，总生存期，预后生物标志物