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Abstract Clinically, the body mass index remains the most frequently used metric of overall obesity, although it is flawed by its inability to account for different adipose (i.e., visceral, subcutaneous, and inter/intramuscular) compartments, as well as muscle mass. Numerous prior studies have demonstrated linkages between specific adipose or muscle compartments to outcomes of multiple diseases. Although there are no universally accepted standards for body composition measurement, many studies use a single slice at the L3 vertebral level. In this study, we use computed tomography (CT) studies from patients in The Cancer Genome Atlas (TCGA) to compare current L3-based techniques with volumetric techniques, demonstrating potential limitations with level-based approaches for assessing outcomes. In addition, we identify gene expression signatures in normal kidney that correlate with fat and muscle body composition traits that can be used to predict sex-specific outcomes in renal cell carcinoma.

Purpose: Proton therapy (PT) for partial breast irradiation (PBI) in early-stage breast cancer can decrease morbidity versus photon PBI with superior organs-at-risk sparing. We report 3-year outcomes of the first prospective, multicenter, phase II trial of proton PBI. Methods and Materials: This Proton Collaborative Group phase II trial (PCG BRE007-12) recruited women ≥ 50 years with node-negative, estrogen receptor (ER)-positive, ≤3cm, invasive ductal carcinoma (IDC) or ductal carcinoma in situ undergoing breast conserving surgery followed by proton PBI (40 Gy(RBE), 10 daily fractions). Primary endpoint was freedom from ipsilateral breast cancer recurrence. Adverse events were prospectively graded using CTCAEv4.0. Breast Cancer Treatment Outcome Scale (BCTOS) assessed patient-reported quality of life (PRQOL). Results: Thirty-eight evaluable patients enrolled between 2/2013–11/2016. Median age was 67 years (range 50–79); 55 % had left-sided disease, and median tumor size was 0.9 cm. Treatment was delivered in ≥ 2 fields predominantly with uniform scanning PT (n = 37). At 35-month median follow-up (12–62), all patients were alive, and none had local, regional or distant disease progression. One patient developed an ER-negative contralateral IDC. Seven grade 2 adverse events occurred; no radiotherapy-related grade ≥ 3 toxicities occurred. Changes in BCTOS subdomain mean scores were maximum 0.36, indicating no meaningful change in PRQOL. Median heart volume receiving 5 Gy (V5Gy), lung V20Gy, and lung V10Gy were 0 %, 0 % and 0.19 %, respectively. Conclusion: At 3 years, proton PBI provided 100 % cancer control for early-stage, ER-positive breast cancer. Toxicities are minimal, and PRQOL remains acceptable with continued follow-up. These findings support PT as a safe and effective PBI delivery option.

Sessile marine invertebrate (biofouling) communities have served as an important model in ecology for evaluating fundamental patterns and processes, including invasion dynamics, which vary at broad spatial and temporal scales. Here, we tested for differences in biofouling community development among three biogeographically distinct bays in North America (Chesapeake Bay, Tampa Bay, and San Francisco Bay), exploring possible explanations for differential non-native species success. In particular, we aimed to examine if San Francisco Bay (a global hotspot for non-native species richness) differed in composition and space occupation, especially since open space can facilitate colonization. Additionally, we explored how biogeography, assembly and succession dynamics over the short and long term, and space availability affect marine communities across broad spatial scales. Patterns of community assembly differed among bays, with more bare space and less secondary cover (species settling on species) in San Francisco Bay. San Francisco Bay was also distinguished by a higher percent cover of Tunicata (almost all of which are non-native and historically absent) over multiple time scales. Cirripedia recruited on bare panels in all three Bays but cover increased only in Tampa Bay, as soak time increased. Tube-dwelling Polychaeta distinguished Chesapeake Bay from Tampa Bay and San Francisco Bay. Low-salinity events temporarily restructured the communities in all three bays. Whether differences among bays reflect coastal versus bay-specific patterns remains to be tested.