Morphologic change of the psoas muscle as a surrogate marker of sarcopenia and predictor of complications after colorectal cancer surgery

Hanaoka, Marie; Yasuno, Masamichi; Ishiguro, Megumi; Yamauchi, Shinichi; Kikuchi, Akifumi; Tokura, Michiyo; Ishikawa, Toshiaki; Nakatani, Eiji; Uetake, Hiroyuki

doi:10.1007/s00384-017-2773-0

Cited by 87 publications

(82 citation statements)

References 20 publications

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Section: Discussionmentioning

confidence: 89%

“…The weak agreement between SMI and HGS confirms that the issue of sarcopenia and dynapenia cutoffs and measurement methods, which vary across literature, have not yet been unanimously established. 8,12,23,24,29,[34][35][36][37][38] Measurement of SMI is only quantitative and does not take into account the quality of the muscle. Edema could overrate SMI measurements.…”

Section: F I G U R E 3 Correlation Betweenmentioning

confidence: 99%

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Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Moreau

Ordan

Barbe³

et al. 2019

Cancer Medicine

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Background FIGHTDIGO study has shown the feasibility of handgrip strength (HGS) measurements in 201 consecutive digestive cancer patients undergoing chemotherapy. Objective This study focuses on a secondary aim of FIGHTDIGO study: the relationship between muscle mass and HGS. Design Two consecutive bilateral measures of HGS were performed using a Jamar dynamometer before the start of each chemotherapy. The highest value was chosen for final evaluation. Dynapenia (loss of muscle strength) was defined as HGS < 30 kg (men) and < 20 kg (women). Muscle mass was measured at lumbar level (L3) on Computed Tomography (CT) scans performed less than 3 weeks before or after the measurement of HGS. Muscle mass loss was defined by skeletal muscle index (SMI) < 53 cm 2 /m 2 (in men with a body mass index (BMI)> 25 kg/m 2 ), < 43 cm 2 /m 2 (in men with a BMI < 25 kg/m 2 ), and < 41 cm 2 /m 2 (in women regardless of BMI). Sarcopenia was defined by the association of a dynapenia and a loss of muscle mass. Results A total of 150 patients were included in this analysis (mean age: 65.6 ± 10.9 years, 87 males (58%), colorectal cancer (47.3%), metastatic stage (76.7%)). A total of 348 CT scans were evaluated. For the 348 measurements, mean SMI and HGS were 41.8 ± 8.7 cm 2 /m 2 and 32.1 ± 11.0 kg, respectively. Muscle mass loss, dynapenia, or sarcopenia were reported at least once, in 120 (80%), 45 (30%), and 30 (20%) patients, respectively. SMI was significantly correlated with HGS (Pearson coefficient = 0.53, P < 0.0001). At concordance analysis, 188 dyad SMI/HGS (54%) were in agreement (Kappa = 0.14 [95% CI, 0.07‐0.21]). Conclusion Correlation between the measurements of HGS and SMI is strong but the concordance between dynapenia and muscle mass loss is poor. Further studies should be performed to confirm the diagnostic thresholds, and to study the chronology of dynapenia and loss of muscle mass.

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Section: Discussionmentioning

confidence: 89%

Section: F I G U R E 3 Correlation Betweenmentioning

confidence: 99%

Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Moreau

Ordan

Barbe³

et al. 2019

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…The premise that psoas should be selected over all other individual muscles, muscle groups, and total muscle mass has not been discussed in the literature nor has any validation been conducted. The choice of psoas is merely stated to be ‘simple and convenient’6 to measure.…”

mentioning

confidence: 99%

Psoas as a sentinel muscle for sarcopenia: a flawed premise

Baracos

2017

J cachexia sarcopenia muscle

181

148

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“…Studies evaluating the association between psoas muscle and mortality in various populations have yielded inconsistent results. [10][11][12]34,35 Discrepancy may arise because of disparate techniques and measurements of psoas muscle, such as PMA, PMI (normalized to patient squared height), 11 right psoas thickness at the level of umbilicus, 10 short-axis to long-axis ratios of the right and left psoas muscles 36 that have been applied to predict clinical outcomes. Because of the asymmetrical shape of psoas muscle, validity and reliability of some of those approaches could be questioned.…”

mentioning

confidence: 99%

Poor performance of psoas muscle index for identification of patients with higher waitlist mortality risk in cirrhosis

Ebadi

Wang

Lai

et al. 2018

J cachexia sarcopenia muscle

118

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BackgroundSarcopenia, characterized by low muscle mass, associates with mortality in patients with cirrhosis. Skeletal muscle area in a single computed tomography image at the level of the third lumbar vertebrate (L3) is a valid representative of whole body muscle mass. Controversy remains regarding applicability of psoas muscle to identify patients at greater risk of mortality. We aimed to determine psoas muscle index (PMI) association with skeletal muscle index (SMI) and to evaluate the capacity of PMI to predict liver transplant waitlist mortality.MethodsWe evaluated listed adult patients with cirrhosis from 2012 to 2013 at four North American liver transplant centres. From L3 computed tomography images within 3 months of listing, we determined SMI and PMI expressed by cm2/m2. Low SMI was defined as SMI <39 cm2/m2 in women and <50 cm2/m2 in men as published by us earlier. Cut‐offs for PMI to predict mortality were established using a receiver‐operating characteristic analysis. Mortality predictors were determined using competing‐risk analysis with reported results as subdistribution hazard ratios (sHRs).ResultsOf 353 waitlist candidates, 68% were men, mean age 56 ± 9 years, and Model for End‐stage Liver Disease of 16 ± 8 points. Low SMI was present more frequently in men than women (51 vs. 36%, P = 0.02). Moderately strong correlation between SMI and PMI was observed (r > 0.7, P < 0.001). Low PMI (males < 5.1 cm2/m2; females < 4.3 cm2/m2) yielded poor and moderate concordance with low SMI in men and women, respectively (Kappa coefficient 0.31 and 0.63). SMI (39 ± 9 vs. 43 ± 7 cm2/m2; P = 0.009) and PMI (4.4 ± 1.3 vs. 5.2 ± 1.1 cm2/m2; P = 0.001) were lower in women who died and/or were delisted (compared with non‐deceased patients) whereas men who died and/or were delisted had only lower SMI (47 ± 7 vs. 51 ± 9 cm2/m2; P = 0.003), but not PMI compared with non‐deceased patients. In women, both SMI (sHR 0.94, P = 0.048) and PMI (sHR 0.58, P = 0.002) were predictors of mortality, while in men, SMI was significant (sHR 0.95, P = 0.001) and PMI showed a trend to be (sHR 0.85, P = 0.09) associated with mortality. Overall, 104 patients (29%) were misclassified between SMI and PMI categories. Using PMI cut‐offs, 66% and 28% of low SMI men and women, who have a higher risk of mortality, were incorrectly classified as low risk.ConclusionsSkeletal muscle index is a more complete and robust measurement than PMI, especially in men with cirrhosis. Low PMI identifies an incomplete subset of patients at increased risk of mortality indicated by low SMI. Given the poor performance of PMI, SMI should not be substituted by PMI.

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Morphologic change of the psoas muscle as a surrogate marker of sarcopenia and predictor of complications after colorectal cancer surgery

Abstract: MPM grade may be used as a simple and convenient marker of sarcopenia and to identify patients at increased risk of complications after colorectal cancer surgery.

Cited by 87 publications

References 20 publications

Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Correlation between muscle mass and handgrip strength in digestive cancer patients undergoing chemotherapy

Psoas as a sentinel muscle for sarcopenia: a flawed premise

Poor performance of psoas muscle index for identification of patients with higher waitlist mortality risk in cirrhosis

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