Prognostic Impact of Quality and Distribution of Adipose Tissue in Patients With Primary Central Nervous System Lymphoma

Background/Aim: Body composition assessment has shown promising results as a prognostic biomarker as depicted by cross-sectional imaging of several tumor entities including lymphomas. The present study sought to elucidate the prognostic relevance of subcutaneous and visceral fat tissue (SAT and VAT) in patients with primary central nervous system lymphoma (PCNSL). Patients and Methods: Overall, 74 patients (36 female patients, 46.7%) with a mean age of 64.2 +/- 12.8 years (range=23-81 years) were identified in the database with sufficient clinical and imaging data and included into this retrospective study. Fat area assessment was performed on one axial slide on L3-height derived from staging computed tomography (CT) images. Subcutaneous, visceral, and intramuscular adipose tissues (SAT, VAT, IMAT) were estimated. Also, density of SAT, VAT, and IMAT were estimated. Finally, the ratio VAT/SAT (VSR) was calculated. Overall and progression-free survival (OS and PFS) were used as study end points. Results: In the observation period, overall, 47 patients (63.5%) died. Mean OS was 33.8 +/- 45.4 months and mean PFS was 26.6 +/- 42.7 months. The mean VAT value was 162 +/- 99.5 cm2 , the mean SAT was 202.4 +/- 103.3 cm2 , the mean VSR was 0.92 +/- 0.69. The hazard ratios (HRs) for overall survival were 0.87 for high VAT, 1.52 for SAT, and 0.73 for VSR in univariable analysis. For PFS it was 0.24 for VAT, 1.11 for SAT, and 1.07 for VSR. No values achieved statistical significance. Similar results were shown in Kaplan -Meier analysis for OS and PFS, respectively. Conclusion: Parameters of adipose tissue are not associated with OS and PFS in patients with PCNSL.