Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

Abstract

Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson’s correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.

Prevalence of Four Sarcopenia Criteria in Older Patients with Cancer, and Their Predictive Value for 6-Month Mortality: The NutriAgeCancer National Prospective Cohort Study

“…Some researchers have investigated the prevalence of sarcopenia in older adults or in patients with cancer (mostly in patients undergoing surgical procedures [ 33 , 34 , 35 ]), but few have focused on older patients with cancer. In a study that included 108 patients with cancer aged ≥60 (mean ± standard deviation age: 70.6 ± 7.4; females: 52.3%, main cancer types: colorectal (27.8%) and gastric (22.2%); advanced cancer: 54.6%), the prevalence of sarcopenia was 24.1% according to the EWGSOP2 definition and 25.9% when using the calf circumference as a proxy for muscle mass [ 36 ]. These prevalence values are very similar to those found in our study when using the AC as a proxy marker of muscle mass.…”

Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients

“…In addition, in the current study, we used reduced CC to identify reduced muscle mass, and it is also a more accessible alternative for clinical practice. Its prognostic value has already been demonstrated in hospitalized patients and its agreement with reference methods for muscle mass assessment [ 39 , 40 ]. We used SGA to diagnose malnutrition since it is considered the reference method for hospitalized patients [ 26 ].…”