Association between preoperative potential sarcopenia and survival of cancer patients undergoing major surgical procedures

Behne, Thayse Emanuelli Godoy; Dock-Nasimento, Diana Borges; Sierra, Jessika Cadavid; Rodrigues, Hadassa Hillary Novaes Pereira; Palauro, Maristela Luft; Andreo, Francilene Oliveira; Silva-The, Mariana Borges; De-Aguilar-Nascimento, José Eduardo

doi:10.1590/0100-6991e-20202528

Cited by 14 publications

(18 citation statements)

References 47 publications

(70 reference statements)

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“…To our knowledge, however, there have been few reports with regard to the relevance between the SARC-F score and prognosis in patients with gastrointestinal advanced cancers [ 27 ]. Such research questions may deserve to be clarified, which urged us to perform the present analysis.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers

Morimoto

Nishikawa

Goto

et al. 2021

Cancers

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We sought to elucidate the prognostic impact of the SARC-F score among patients with gastrointestinal advanced malignancies (n = 421). A SARC-F score ≥ 4 was judged to have a strong suspicion for sarcopenia. In patients with ECOG-PS 4 (n = 43), 3 (n = 61), and 0–2 (n = 317), 42 (97.7%), 53 (86.9%) and 8 (2.5%) had the SARC-F score ≥ 4. During the follow-up period, 145 patients (34.4%) died. All deaths were cancer-related. The 1-year cumulative overall survival (OS) rate in patients with SARC-F ≥ 4 (n = 103) and SARC-F < 4 (n = 318) was 33.9% and 61.6% (p < 0.0001). In the multivariate analysis for the OS, total lymphocyte count ≥ 1081/μL (p = 0.0014), the SARC-F score ≥ 4 (p = 0.0096), Glasgow prognostic score (GPS) 1 (p = 0.0147, GPS 0 as a standard), GPS 2 (p < 0.0001, GPS 0 as a standard), ECOG-PS 2 (p < 0.0001, ECOG-PS 0 as a standard), ECOG-PS 3 (p < 0.0001, ECOG-PS 0 as a standard), and ECOG-PS 4 (p < 0.0001, ECOG-PS 0 as a standard) were independent predictors. In the receiver operating characteristic curve analysis on the prognostic value of the SARC-F score, the sensitivity/specificity was 0.59/0.70, and best cutoff point of the SARC-F score was two. In conclusion, the SARC-F score is useful in patients with gastrointestinal advanced malignancies.

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Section: Introductionmentioning

confidence: 99%

Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers

Morimoto

Nishikawa

Goto

et al. 2021

Cancers

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“…This comparison of instruments was also evaluated in another Chinese study, but the incidence of mortality was not evaluated ( 11 ). Studies in the United States ( 13 ) and Brazil ( 14 ) evaluated the role of the SARC-F score as a risk factor for mortality, while previous studies in India ( 34 ), and Brazil ( 35 ) evaluated SARC-F in adults from 30 years and older adults with cancer. Likewise, the role of the SARC-CalF score as a risk factor for mortality was evaluated in a study in Brazil ( 36 ); however, this study included older adults without cancer.…”

Section: Discussionmentioning

confidence: 99%

“…We evaluated the risk of sarcopenia only in older men, while previous studies included both sexes, thus, reporting a higher frequency of risk of sarcopenia in men compared to women (11,13). This is important as a previous study described that adults with cancer and at risk of sarcopenia were more likely to die after major surgery, especially gastrointestinal operations (14). In addition, the risk of sarcopenia in older men may increase in the short term after receiving chemotherapy, radiotherapy or chemo-radiotherapy with curative intent (34), as well as predict lower survival (13).…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

“…SARC-CalF is an instrument to which the measurement of calf circumference was added, increasing the sensitivity from 29.5-33.3% to 60.7-66.7% (11,12). Previous studies have been conducted using the SARC-F and/or SARC-CalF scales for screening of the risk of sarcopenia in older adults with cancer in the United States (13) and Brazil (14,15). However, these studies had limitations due to the short follow-up time and study population (13)(14)(15), in addition to having a crosssectional design that did not allow causal association to be evaluated in one of these studies (15).…”

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confidence: 99%

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SARC-F and SARC-CalF Scores as Mortality Risk Factors in Older Men with Cancer: A Longitudinal Study from Peru

Ururi-Cupi

Oliva-Zapata

Salazar-Talla

et al. 2022

The Journal of nutrition, health and aging

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Objectives We aimed to evaluate the role of SARC-F and SARC-CalF scores as risk factors for mortality in adults over 60 years of age with cancer of the Centro Médico Naval (CEMENA) in Callao, Peru during 2012–2015. Methods We performed a secondary analysis of data from a prospective cohort carried out from September 2012 to February 2013 in the Geriatrics Department of CEMENA. The outcome variable was mortality at two years of follow-up, while the exposure variable was the risk of sarcopenia assessed using the SARC-F and SARC-CalF scales. We carried out Cox proportional-hazards models to assess the role of SARC-F and SARC-CalF scores as risk factors for mortality. We estimated crude (cHR) and adjusted (aHR) hazard ratios (HR) with their respective 95% confidence intervals (95%CI). Likewise, we calculated the area under the curve (AUC) of both exposure variables in relation to mortality. Results We analyzed data from 922 elderly men with cancer; 43.1% (n=397) were between 60 and 70 years old. 21.5% (n=198) and 45.7% (n=421) were at risk of sarcopenia according to SARC-F and SARC-CalF, respectively, while the incidence of mortality was 22.9% (n=211). In the adjusted Cox regression model, we found that the risk of sarcopenia measured by SARC-F (aHR=2.51; 95%CI: 1.40–2.77) and SARC-CalF (aHR=2.04; 95%CI: 1.55–4.02) was associated with a higher risk of death in older men with cancer. In the diagnostic performance analysis, we found that the AUC for mortality prediction was 0.71 (95%CI: 0.68–0.75) for SARC-F and 0.80 (95%CI: 0.78–0.82) for SARC-CalF. Conclusions The risk of sarcopenia evaluated by SARC-F and SARC-CalF scores was associated with an increased risk of mortality in older men with cancer. Both scales proved to be useful and accessible instruments for the identification of groups at risk of mortality. Electronic Supplementary Material Supplementary material is available in the online version of this article at 10.1007/s12603-022-1844-2.

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“…Ainda acrescenta que esse questionário apresenta uma sensibilidade de moderada a baixa e uma alta especificidade 11 . Neste sentido, um artigo recente desse grupo mostrou que pacientes em risco de sarcopenia, pelo SARC-F, que apresentavam também baixa força de preensão palmar, foram os que se comportaram com maior risco de complicações infecciosas no pós--operatório 24 . Também, Barbosa-Silva et al 25 , em 2016, mostraram que a avaliação do SARC-F combinado com a circunferência da panturrilha (SARC-CalF) foi mais sensível para detectar pacientes em risco de sarcopenia quando comparados ao SARC-F isolado (p=0,027).…”

Section: Métodounclassified

Risco Nutricional versus Risco de Sarcopenia Associado a Complicações Pós-Operatórias e Mortalidade em Pacientes Oncológicos Submetidos a Cirurgias de Grande Porte

Rodrigues¹,

Palauro²,

Behne³

et al. 2021

Rev. Bras. Cancerol.

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Introdução: Pacientes cirúrgicos, que apresentam risco nutricional ou de sarcopenia, podem evoluir com piores desfechos no pós-operatório. Objetivo: Investigar se existe associação entre o risco nutricional e a sarcopenia com complicações e mortalidade no pós-operatório de pacientes oncológicos submetidos a cirurgias de grande porte. Método: Estudo biocêntrico de coorte, prospectivo, realizado com 220 pacientes oncológicos adultos, submetidos a operações de grande porte no Hospital de Câncer e na Santa Casa de Misericórdia em Cuiabá, Mato Grosso. Os pacientes foram classificados com ou sem risco nutricional pela Nutritional Risk Screening 2002 e de sarcopenia segundo o questionario Strength, Assistance with walking, Rise from a chair, Climb stairs - and Falls, no pré-operatório. As variáveis de desfecho foram complicações infecciosas e óbito no pós-operatório. Resultados: Os pacientes com risco nutricional mostraram maior risco de complicações infecciosas (24,6 vs. 5,1%; RR=4,8 IC95% 1,94-12; p<0,001) e de óbito (11,5 vs. 1,0%; RR=11,2 IC95%1,5-84,0; p=0,002) no pós-operatório, quando comparados aos sem risco nutricional. Não houve associação do risco de sarcopenia com a presença de complicações infecciosas e óbito ao longo do período pós-operatório (p>0,05). Conclusão: Os pacientes oncológicos em risco nutricional foram aqueles que apresentaram maior risco de complicações infecciosas e de óbito no pós-operatório, quando comparados aos sem risco nutricional ou em risco de sarcopenia.

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Association between preoperative potential sarcopenia and survival of cancer patients undergoing major surgical procedures

Cited by 14 publications

References 47 publications

Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers

Prognostic Impact of the SARC-F Score in Gastrointestinal Advanced Cancers

SARC-F and SARC-CalF Scores as Mortality Risk Factors in Older Men with Cancer: A Longitudinal Study from Peru

Risco Nutricional versus Risco de Sarcopenia Associado a Complicações Pós-Operatórias e Mortalidade em Pacientes Oncológicos Submetidos a Cirurgias de Grande Porte

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