Temporalis Muscle Thickness Predicts CNS Lymphoma Survival

M. Alexander Otto, MMS, PA

December 09, 2021

Key Takeaway

  • Sarcopenia measured by temporalis muscle thickness (TMT) robustly and independently predicts early relapse and short survival in primary central nervous system (CNS) lymphoma.

  • Very thin TMT is a better predictor of mortality than the International Extranodal Lymphoma Study Group score and the Memorial Sloan Kettering Cancer Center prognostic model.

Why This Matters

  • Most patients with primary CNS lymphoma achieve long-term remission, but about 20% have aggressive disease and die in the first year.

  • TMT can distinguish these two groups and inform decisions between aggressive management or palliative control.

Study Design

  • Two blinded operators retrospectively measured TMT in 99 consecutive pretreatment brain MRIs from patients who were subsequently diagnosed with primary CNS lymphoma.

  • Patients with TMT less than one standard deviation below the group mean were considered to have very thin TMT.

Key Results

  • Fifteen patients met the very thin mark, with TMT below 6 mm.

  • On multivariate analysis controlling for age, sex, TMT, performance status, body mass index, consolidation, and lifetime methotrexate dose, very thin TMT was independently associated with both early progression (HR, 7.87; P < .001) and short survival (HR, 4.49; P < .001).


  • MRI technique was not standardized, which might have affected TMT measurements.

  • The optimal cutoff value for TMT needs to be validated in a prospective study.


  • There was no funding for the work. The investigators did not report any disclosures.

This is a summary of a preprint research report led by Alipi Bonm at the University of Washington, Seattle, provided to you by Medscape. This study has not yet been peer-reviewed. The full text can be found at researchsquare.com.

M. Alexander Otto is a physician assistant with a master's degree in medical science. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape and is an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

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