Prevalence of Sarcopenia and Its Relationship with Nutritional State and Quality of Life in Patients with Digestive Diseases

Onishi, Sachiyo; Shiraki, Makoto; Nishimura, Kayoko; Hanai, Taizo; Moriwaki, Hisataka; Shimizu, Masahito

doi:10.3177/jnsv.64.445

Cited by 22 publications

(17 citation statements)

References 31 publications

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“…As male patients had significantly higher baseline hemoglobin levels with a higher SMI we additionally analyzed the association between sarcopenia and hemoglobin levels using the sex specific cut-offs, and found that patients with sarcopenia had lower baseline hemoglobin levels independent of sex. This is in line with published data on sarcopenia ( 21 ). A link between chronic inflammation and sarcopenia has been proposed ( 14 , 22 ).…”

Section: Discussionsupporting

confidence: 93%

Sarcopenia Is Associated With Hematologic Toxicity During Chemoradiotherapy in Patients With Anal Carcinoma

et al. 2020

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Purpose Sarcopenia, defined as a loss of muscle mass and quality, has been associated with impaired oncological outcome and treatment toxicities in several malignancies. However, its role in anal squamous cell carcinoma (ASCC) remains less well explored. Methods/Materials Planning CT scans were used to measure cross-sectional skeletal muscle area (SMA) to calculate the skeletal muscle index (SMI). The association of sarcopenia with clinical and treatment-related parameters, and toxicity was assessed in 114 patients with ASCC that underwent standard 5-Fluorouracil/Mitomycin C chemoradiotherapy (CRT). The prognostic impact of sarcopenia on local relapse-free survival (LRFS), disease-free survival (DFS), and overall survival was examined using a Cox regression analysis. Results 29 (25.4%) patients had sarcopenia. Patients with sarcopenia had lower baseline hemoglobin levels ( p = 0.002), worse Karnofsky Performance Status ( p = 0.001) lower BMI ( p < 0.001), and a significantly lower body surface area ( p = 0.03), and lower incidence of involved lymph nodes ( p = 0.03). Regarding acute toxicity, sarcopenia was associated with a significantly higher incidence of ≥grade 3leukopenia (OR: 3.5; 95% CI: 1.6–7.5, p = 0.007) and ≥grade 3 thrombopenia (OR: 5.1; 95% CI: 1.3–21, p = 0.018) after CRT. Despite higher hematologic toxicity in sarcopenic patients, total treatment time was similar between patients with and without sarcopenia (median 44 vs 45 days, p = 0.95). There was no significant prognostic impact of sarcopenia on either LRFS, DFS, or OS. Conclusion This is the largest study to assess the impact of sarcopenia on toxicity and oncological outcome in patients with ASCC. Increased clinician awareness of higher hematological toxicity risk is needed for sarcopenic patients with ASCC undergoing CRT to facilitate closer monitoring of side effects and earlier introduction of supportive measures. Further prospective studies are needed to elucidate the prognostic role and impact of sarcopenia on CRT-related toxicity in ASCC.

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Section: Discussionsupporting

confidence: 93%

Sarcopenia Is Associated With Hematologic Toxicity During Chemoradiotherapy in Patients With Anal Carcinoma

et al. 2020

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“…Multivariable proportional odds logistic analysis indicated that malaise, edema of the limbs, peripheral sensory neuropathy, pruritus, and dry skin were significant factors for reducing the EQ-5D-5L utility value. Several reports support the present results, highlighting the association between adverse events and decreased QOL [8,[19][20][21]. Secondary analysis using proportional odds logistic regression did not show a significant association between QOL and cancer type or anticancer drugs.…”

Section: Discussionsupporting

confidence: 84%

“…Limb edema is a characteristic finding in patients with malnutrition. Onishi et al [19] reported that malnutrition in cancer patients is associated with decreased QOL. Additionally, Hershman et al, using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity, reported that QOL scores decreased from 37.5 to 28.7 post-treatment (P = 0.0002).…”

Section: Discussionmentioning

confidence: 99%

Real-world data of the association between quality of life using the EuroQol 5 Dimension 5 Level utility value and adverse events for outpatient cancer chemotherapy

Hirose

Fujii

Iihara

et al. 2020

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Background Outpatient cancer chemotherapy may lead to improved quality of life (QOL) by allowing treatment to continue without impairing the social lives of patients compared with hospitalization. However, the occurrence of serious adverse events may cause a decline in QOL. We investigated the relationship between outpatient chemotherapy-induced adverse events and QOL. Methods A single-center retrospective descriptive study was conducted in patients who received outpatient chemotherapy at Gifu University Hospital (Gifu, Japan) between September 2017 and December 2018. The utility values of QOL, type and severity of adverse events, type of cancer, chemotherapy regimen, and other patient demographics were analyzed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L). Associations between the EQ-5D-5L utility value and serious adverse events were assessed using adjusted (age and sex) odds ratios obtained with a proportional odds logistic regression model. Results Data from 1008 patients who received 4695 chemotherapy cycles were analyzed. According to proportional odds logistic regression, the adverse events that significantly correlated with a decreased EQ-5D-5L utility value were malaise, edema of the limbs, peripheral neuropathy, pruritus, and dry skin. Based on the proportional odds logistic analysis, neither cancer type nor anticancer drugs were significantly correlated with the EQ-5D-5L utility value in patients who received chemotherapy. Pharmaceutical care for peripheral neuropathy significantly improved patients' EQ-5D-5L utility value from 0.747 to 0.776 (P < 0.01). Conclusions Adverse events (i.e., peripheral neuropathy, malaise, and edema of the limbs) are significantly correlated with a decrease in QOL, regardless of the type of cancer or anticancer drugs used. Pharmaceutical care provided by pharmacists in collaboration with physicians may improve QOL.

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“…Sarcopenia, low muscle mass and low muscle strength result in a deteriorated clinical course of liver disease. [ 25 , 26 ] In addition, low muscle mass is associated with impaired HRQOL among patients with liver disease. Although we could not identify an association between ASMI and HRQOL, hand grip tended to be positively associated with the activity domain.…”

Section: Discussionmentioning

confidence: 99%

Quality of life among patients with autoimmune hepatitis in remission

et al. 2020

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Health-related quality of life (HRQOL) is lower in individuals with autoimmune hepatitis (AIH) than in the general population. However, previous evaluations of HRQOL for AIH have included a broad range of disease activities. The aim of this study was to clarify HRQOL among patients with AIH in remission. We assessed HRQOL in patients with AIH in remission, patients with chronic hepatitis C (CHC) with eradicated hepatitis C virus (HCV) and patients with primary biliary cholangitis (PBC) using the Japanese version of the Chronic Liver Disease Questionnaire (CLDQ). Participants comprised 62 patients with AIH in remission, 39 patients with CHC with eradicated HCV and 66 patients with PBC. Median ages of patients were 63, 69, and 64 years, respectively. Overall score (5.6 vs 5.9, P = .02) and fatigue (5.2 vs 5.6, P = .01) and worry (5.6 vs 6.0, P = .01) domain scores of the CLDQ were significantly lower in patients with AIH in remission than in CHC with eradicated HCV, and similar to scores except for the systemic symptoms domain in patients with PBC. Disease duration was associated with lower scores on systemic symptoms and activity domains of the CLDQ in patients with AIH in remission. Patients with AIH in remission show impaired HRQOL associated with disease duration.

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Prevalence of Sarcopenia and Its Relationship with Nutritional State and Quality of Life in Patients with Digestive Diseases

Cited by 22 publications

References 31 publications

Sarcopenia Is Associated With Hematologic Toxicity During Chemoradiotherapy in Patients With Anal Carcinoma

Sarcopenia Is Associated With Hematologic Toxicity During Chemoradiotherapy in Patients With Anal Carcinoma

Real-world data of the association between quality of life using the EuroQol 5 Dimension 5 Level utility value and adverse events for outpatient cancer chemotherapy

Quality of life among patients with autoimmune hepatitis in remission

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