Muscle composition and outcomes in patients with breast cancer: meta-analysis and systematic review

Aleixo, Gabriel F. P.; Williams, Grant R.; Nyrop, Kirsten A.; Muss, Hyman B.; Shachar, Shlomit Strulov

doi:10.1007/s10549-019-05352-3

Cited by 85 publications

(62 citation statements)

References 52 publications

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“…Another study looked at the relationships amongst quality of life, muscle mass, and muscle function in 200 inactive breast cancer patients receiving adjuvant chemotherapy and found that both sarcopenia and dynapenia (poor muscle function compared to age- and sex-based norms) were associated with poor quality of life ( 92 ). Sarcopenia has also been associated with toxicity in the setting of advanced breast cancer; a meta-analysis including four observational studies evaluating the relationship between sarcopenia and outcomes in women with advanced cancer receiving chemotherapy demonstrated that patients with metastatic disease with sarcopenia had a two-fold risk of grade 3–5 toxicity as compared to patients who were not sarcopenic (RR: 2.17, 95% CI: 1.4–3.34, P=0.0005) ( 93 ).…”

Section: Sarcopenia and Treatment Toxicity In Cancer Patientsmentioning

confidence: 99%

“…While sarcopenia is associated with multiple comorbidities in patients with cancer, its effects may be even more severe in older patients with cancer ( 34 ). In different series, sarcopenia has been identified before therapeutic intervention in 14% to 74% of cancer patients ( 34 , 97 – 99 ) where it has been shown to be associated with increased surgical complications, increased chemotherapy toxicity, and poorer outcomes, including poorer survival in multiple malignancies, including lung, breast, colorectal, renal cell, ovarian, hepatocellular cancer, and lymphoma ( 34 , 44 , 58 , 93 , 100 – 104 ). Older cancer patients with sarcopenia have been shown to experience increased toxicity with multiple chemotherapeutic agents including 5FU, capecitabine, cisplatin, anthracyclines, taxanes, etoposide, and cyclophosphamide ( 34 , 99 – 105 ).…”

Section: Sarcopenia and Treatment Toxicity In Older Cancer Patientsmentioning

confidence: 99%

“…Sarcopenia alone was also linked to higher mortality (HR: 1.41, 95% CI: 1.18–1.69). These data and several other reports were included in a recent meta-analysis by Aleixo and colleagues looking at the relationship between muscle mass and outcomes in women receiving chemotherapy for early-stage (four studies) and advanced (four studies) breast cancer ( 93 ). The overall prevalence of sarcopenia reported in these studies was 39.8% (range, 25–66.9%).…”

Section: Sarcopenia and Cancer Mortalitymentioning

confidence: 99%

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Sarcopenia in aging, obesity, and cancer

Ligibel

Schmitz

Berger

2020

Transl Cancer Res TCR

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Sarcopenia, defined as loss of muscle mass, strength and physical performance, is a hallmark of aging and is invariably associated with perturbation of amino acid metabolism, increased muscle protein catabolism relative to anabolism, and loss of muscle fibers. Sarcopenia may be associated with general loss of body mass, or it may also occur along with obesity [sarcopenic obesity (SO)]. Although sarcopenia is associated with multiple comorbidities in older adults, its effects may even be more severe in patients with malignant disease where it has been shown to contribute to poor surgical outcomes, increased chemotherapy toxicity associated with both cytotoxic and targeted agents, as well as adversely impacting survival. While development of sarcopenia is a common age-related phenomenon, the associated catabolic processes appear to be promoted by physical inactivity, inadequate nutrition, and systemic low-grade inflammation, as well as intrinsic muscle and molecular changes, including mitochondrial dysfunction and impaired muscle stem cell regenerative capacity. Increased physical activity and adequate protein intake can reduce incidence and severity of sarcopenia in cancer patients, but many older cancer patients do not meet physical activity and nutrition recommendations, and cancer treatment can make it more difficult to make favorable lifestyle changes. Sarcopenia is discussed in terms of its adverse clinical consequences in older subjects and particularly, in older patients with cancer. Contributions of lifestyle, molecular, and cellular factors are likewise reviewed with suggestions for interventions to improve sarcopenia and its comorbid sequalae.

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Section: Sarcopenia and Treatment Toxicity In Cancer Patientsmentioning

confidence: 99%

Section: Sarcopenia and Treatment Toxicity In Older Cancer Patientsmentioning

confidence: 99%

Section: Sarcopenia and Cancer Mortalitymentioning

confidence: 99%

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Sarcopenia in aging, obesity, and cancer

Ligibel

Schmitz

Berger

2020

Transl Cancer Res TCR

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“…Recently, sarcopenia as defined by low skeletal muscle mass and low skeletal muscle function has been gaining much interest due to its prognostic impact in cancer patients [36][37][38][39]. A recent meta-analysis regarding outcome in PaC patients receiving surgery reported that sarcopenia was associated with increased peri-operative mortality and decreased OS [37].…”

Section: Discussionmentioning

confidence: 99%

Proposal of predictive model on survival in unresectable pancreatic cancer receiving systemic chemotherapy

et al. 2020

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Aims:To construct a predictive model for overall survival (OS) in unresectable pancreatic cancer (PaC) undergoing systemic chemotherapy and to confirm its accuracy in an independent cohort. Patients and methods: The training set (Ts) and the validation set (Vs) included 93 patients (median age=71 years) and 75 patients (median age=76 years). In the Ts, we examined variables linked to OS by uni-and multivariate analyses and constructed a predictive model for OS. Next, we evaluated the reproducibility of the proposed model in the Vs. Results: In the multivariate analysis for the Ts, PaC stage IV (P=0.0020) and carbohydrate antigen (CA) 19-9 >437.5 IU/l (P=0.0237) were identified to be significant factors associated with OS. Patients with PaC stage IV or not were given a score of 1 or 0, whereas patients with CA19-9 >437.5 IU/l or <437.5 IU/l were given a score of 1 or 0. Sum of the point of PaC stage (0 or 1) and CA19-9 (0 or 1) was defined as "PaC-CA score". In the Ts, there were 16 patients with score 0, 40 with score 1 and 37 with score 2, while in the Vs, there were 9 patients with score 0, 32 with score 1 and 34 with score 2. Overall P values reached significance in the Ts (P=0.0002), the Vs (P=0.0029) and the combined Ts and Vs (P<0.0001) among patients with PaC score 0, 1 and 2. Conclusion: PaC-CA score can be helpful for risk stratification in PaC patients undergoing systemic chemotherapy.

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“…Glutamine is an important nitrogen donor in intracellular metabolism and in the maintenance of intestinal tract, immune cells, and muscle [ 1 , 2 , 3 , 4 , 5 , 6 ]. Weight loss in cancer patients is common, but sarcopenia (loss of muscle mass) is associated with increased complications and significantly worse survival [ 7 , 8 , 9 , 10 ]. Glutamine is a preferred fuel for both lymphocytes [ 11 , 12 ] and gastrointestinal (GI) tract [ 1 ], thus it plays an important role in helping to defend against infections and to assist mucosa in being a barrier against infection ( Figure 1 ).…”

Section: Importance Of Glutaminementioning

confidence: 99%

Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy

Anderson

Lalla

2020

Nutrients

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Glutamine is a major dietary amino acid that is both a fuel and nitrogen donor for healing tissues damaged by chemotherapy and radiation. Evidence supports the benefit of oral (enteral) glutamine to reduce symptoms and improve and/or maintain quality of life of cancer patients. Benefits include not only better nutrition, but also decreased mucosal damage (mucositis, stomatitis, pharyngitis, esophagitis, and enteritis). Glutamine supplementation in a high protein diet (10 grams/day) + disaccharides, such as sucrose and/or trehalose, is a combination that increases glutamine uptake by mucosal cells. This increased topical effect can reduce painful mucosal symptoms and ulceration associated with chemotherapy and radiation in the head and neck region, esophagus, stomach and small intestine. Topical and oral glutamine seem to be the preferred routes for this amino acid to promote mucosal healing during and after cancer treatment.

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Muscle composition and outcomes in patients with breast cancer: meta-analysis and systematic review

Cited by 85 publications

References 52 publications

Sarcopenia in aging, obesity, and cancer

Sarcopenia in aging, obesity, and cancer

Proposal of predictive model on survival in unresectable pancreatic cancer receiving systemic chemotherapy

Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy

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