Low preoperative skeletal muscle index increases the risk of mortality among resectable pancreatic cancer patients: A retrospective study

Figure 1 Selective representative computed tomography images with tag overlay at the third lumbar vertebra level from two individual patients with pancreatic cancer presenting with similar body mass index (21. 45 kg/m² in patient A and 21.48 kg/m² in patient B). The red, yellow and green shadows indicate the skeletal muscle area (SMA), visceral adipose tissue area (VATA), and subcutaneous adipose tissue area (SATA), respectively. Skeletal muscle index, subcutaneous adipose tissue index and visceral adipose tissue index were calculated from SATA, VATA, and SMA divided by height in meters squared, respectively. The visceral to subcutaneous adipose tissue area ratio was calculated by dividing VATA by SATA. Skeletal muscle density indicates the mean computed tomography value (HU) of SMA. A: Body mass index (BMI): 21.45; B: BMI: 21.48. SMI: Skeletal muscle index; SATI: Subcutaneous adipose tissue index; VATI: Visceral adipose tissue index; VSR: Visceral to subcutaneous adipose tissue area ratio; SMD: Skeletal muscle density; HU: Hounsfield unit.

Figure 2 Kaplan Meier survival curves for overall survival and recurrence-free survival based on skeletal muscle index and skeletal muscle density. A and C: Overall survival (OS) and recurrence-free survival (RFS) curves for patients with low and high skeletal muscle index; B and D: OS and RFS curves for patients with low and high skeletal muscle density. SMI: Skeletal muscle index; SMD: Skeletal muscle density.

Figure 3 Kaplan Meier overall survival curves of the cohort stratified by age. A and C: Overall survival (OS) curves for patients aged 65 and older stratified according to skeletal muscle index (SMI) (A) and skeletal muscle density (SMD) (C); B and D: OS curves for patients aged younger than 65 yr stratified by SMI (B) and SMD (D). SMI: Skeletal muscle index; SMD: Skeletal muscle density.