Incidence and risk factor analysis for sarcopenia in patients with cancer

Zhang, Guoxing; Li, Xiujiang; Sui, Changping; Zhao, Hui; Zhao, Jianhua; Hou, Yue; Du, Yujun

doi:10.3892/ol.2015.4019

Cited by 36 publications

(39 citation statements)

References 25 publications

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“…11,29,31 Previous studies have confirmed the association of many of these inflammatory biomarkers with sarcopenia. 27,32,33 In our study, we exploratorily evaluate the variation of these inflammatory indexes, but some of them were not associated with early LSMM, probably owing to the small sample size of the study and its retrospective nature.…”

Section: Discussionmentioning

confidence: 97%

“…Cachexia is defined as a body weight loss over 12 months of 5% or more; conversely, sarcopenia defines metabolic disorders that include LSMM, atrophy, fatigue, and reduction of muscular strength. During this process, muscle fibres are replaced by fibrotic tissue, resulting in neuromuscular junction degeneration, increased levels of reactive oxygen species alterations, and altered muscle metabolism . Nowadays, the best index to identify sarcopenic patients is still under debate, as well as the nutritional follow‐up …”

Section: Discussionmentioning

confidence: 99%

“…No association was observed with other inflammatory indexes or with body weight loss. Notably, markers of systemic inflammation, such as NLR, are correlated with high levels of cytokines resulting in modulation of several factors (IGF‐1/Akt/mTOR axis, FoxOs, NF‐κB, and MAPK) favouring a catabolic state . More specially, IGF‐1 stimulates protein synthesis and promotes muscle hypertrophy; Akt/protein kinase B and FoxO are responsible for muscle homeostasis by regulating cell metabolism, growth, and survival.…”

Section: Discussionmentioning

confidence: 99%

“…During this process, muscle fibres are replaced by fibrotic tissue, resulting in neuromuscular junction degeneration, increased levels of reactive oxygen species alterations, and altered muscle metabolism. 27,28 Nowadays, the best index to identify sarcopenic patients is still under debate, as well as the nutritional follow-up. 4 Many studies are trying to clarify the molecular pathways underlying muscle wasting.…”

Section: Discussionmentioning

confidence: 99%

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The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

Basile

Parnofiello

Vitale

et al. 2019

J cachexia sarcopenia muscle

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Background Pancreatic cancer (PC) patients have multiple risk factors for sarcopenia and loss of skeletal muscle mass (LSMM), which may cause greater treatment toxicities, reduced response to cancer therapy, prolonged hospitalization, impaired quality of life, and worse prognosis. Methods This is a retrospective study on advanced PC patients treated at the Department of Oncology of Udine, Italy, from January 2012 to November 2017. Among 162 patients who received chemotherapy, 94 consecutive patients with an available computed tomography (CT) scan were retrospectively analyzed. The primary objective of our study was to explore if an early LSMM ≥ 10% (measured at first radiological evaluation and compared with baseline) and/or baseline sarcopenia may impact prognosis. Baseline sarcopenia was defined according to Prado's criteria. Skeletal muscle area was measured as cross‐sectional areas (cm 2 ) using CT scan data through the Picture archiving and communication system (PACS) image system. Results In the whole cohort, 48% of patients were ≤70 years old, and 50% had metastatic disease. At baseline, 73% of patients had sarcopenia, and 16% presented a visceral fat area ≥ 44 cm 2 /m 2 . Overall, 21% experienced an early LSMM ≥ 10%. Approximately 33% of sarcopenic patients at baseline and ~35% of patients with early LSMM ≥ 10% had a body mass index > 25 kg/m 2 . Of note, 71% of patients were evaluated by a nutritionist, and 56% received a dietary supplementation (oral and/or parenteral). After a median follow‐up of 30.44 months, median overall survival (OS) was 11.28 months, whereas median progression‐free survival (PFS) was 5.72 months. By multivariate analysis, early LSMM ≥ 10% was significantly associated with worse OS [hazard ratio (HR): 2.16; 95% confidence interval (CI) 1.23–3.78; P = 0.007] and PFS (HR: 2.31; 95% CI 1.30–4.09; P = 0.004). Moreover, an exploratory analysis showed that inflammatory indexes, such as neutrophil–lymphocyte ratio variation, impact early LSMM ≥ 10% (odds ratio 1.31, 95% CI 1.06–1.61, P = 0.010). Conclusions Early LSMM ≥ 10% has a negative prognostic role in advanced PC patients. Further prospective investigations are needed to confirm these preliminary data.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

Basile

Parnofiello

Vitale

et al. 2019

J cachexia sarcopenia muscle

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“…Sarcopenia, defined as decreased skeletal muscle mass Original Article Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multiinstitutional analysis and strength two standard deviations below that of healthy adults, has been used as a clinically significant marker of biological age, and has been found to be associated with functional impairment, perioperative complications, and decreased survival in patients with nonmalignant conditions (4)(5)(6). Changes in body composition on computed topography (CT) imaging occur after neoadjuvant treatment in many cancers, including esophageal and breast cancer (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Mirkin¹,

Luke²,

Gangi³

et al. 2017

J. Gastrointest. Oncol.

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Background: This study's objective was to evaluate the change in sarcopenia score following neoadjuvant chemotherapy (NAC) and to correlate both sarcopenia and change in score with perioperative outcomes in patients with advanced resected gastric cancer.Methods: Multi-institutional analysis of patients with gastric cancer who underwent NAC and resection from 2000-2015 was performed. Demographic and perioperative data were included. Sarcopenia score was defined as CT measurement of total psoas muscle at L3, stratified by height (m). Sarcopenia was defined as a score <385 mm 2 /m 2 in women and <545 mm 2 /m 2 in men.Results: Of 36 patients, 19% were sarcopenic prior to NAC. Following NAC, 31% were sarcopenic, with 14% developing sarcopenia during NAC. One patient (3%) became non-sarcopenic. There were no significant differences in patient, disease, or surgery characteristics between patients who were sarcopenic vs.not. Patients with sarcopenia were more likely to have post-operative complications (P=0.05). There was no significant difference in hospital stay (P=0.7402) or survival (P=0.2317).Conclusions: A significant number of patients with gastric cancer become sarcopenic during NAC.Although patients with sarcopenia were nearly twice as likely to develop post-operative complications, this did not appear to impact length of stay (LOS) or survival. and strength two standard deviations below that of healthy adults, has been used as a clinically significant marker of biological age, and has been found to be associated with functional impairment, perioperative complications, and decreased survival in patients with nonmalignant conditions (4-6). Changes in body composition on computed topography (CT) imaging occur after neoadjuvant treatment in many cancers, including esophageal and breast cancer (7)(8)(9)(10).This study sought to understand the impact of NAC on sarcopenia and to evaluate whether sarcopenia is correlated with perioperative outcomes in patients with advanced resected gastric cancer. Methods Patient selectionThis was a multi-institutional, retrospective cohort study. Records of patients who underwent NAC and surgery for gastric adenocarcinoma at Penn State Hershey Medical Center and Moffitt Cancer Center from March 2000 to April 2015 were reviewed. Only patients who had both pre-NAC and post-NAC CT or positron emission tomography (PET-CT) scans, were included in final analysis. Outcomes and covariatesPatient characteristics [including age, sex, body mass index (BMI), comorbidities, pre-operative weight], disease characteristics [American Joint Committee on Cancer (AJCC) T and N stage, tumor size, lymph nodes], and treatment characteristics (surgical approach, type of resection, NAC regimen, surgical margins) were retrospectively collected from the electronic medical record. Post-operative complications, hospital length of stay (LOS), and overall survival were the primary outcomes. Surgical complications were classified by the Clavien-Dindo Classification of Surgical Complications Scale, which grades com...

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Epidemiology of Sarcopenia: Determinants Throughout the Lifecourse

2017

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Sarcopenia is an age-related syndrome characterised by progressive and generalised loss of skeletal muscle mass and strength; it is a major contributor to the risk of physical frailty, functional impairment in older people, poor health-related quality of life and premature death. Many different definitions have been used to describe sarcopenia and have resulted in varying estimates of prevalence of the condition. The most recent attempts of definitions have tried to integrate information on muscle mass, strength and physical function and provide a definition that is useful in both research and clinical settings. This review focuses on the epidemiology of the three distinct physiological components of sarcopenia, and highlights the similarities and differences between their patterns of variation with age, gender, geography and time and the individual risk factors that cluster selectively with muscle mass, strength and physical function. Methods used to measure muscle mass, strength and physical functioning and how differences in these approaches can contribute to the varying prevalence rates will also be described. The evidence for this review was gathered by undertaking a systematic search of the literature. The descriptive characteristics of muscle mass, strength and function described in this review point to the urgent need for a consensual definition of sarcopenia incorporating these parameters.

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Incidence and risk factor analysis for sarcopenia in patients with cancer

Cited by 36 publications

References 25 publications

The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

The IMPACT study: early loss of skeletal muscle mass in advanced pancreatic cancer patients

Sarcopenia related to neoadjuvant chemotherapy and perioperative outcomes in resected gastric cancer: a multi-institutional analysis

Epidemiology of Sarcopenia: Determinants Throughout the Lifecourse

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