Sarcopenia versus cancer cachexia: the muscle wasting continuum in healthy and diseased aging

Moreira‐Pais, Alexandra; Ferreira, Rita; Oliveira, Paula A.; Duarte, José Alberto

doi:10.1007/s10522-021-09932-z

Cited by 13 publications

(6 citation statements)

References 183 publications

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“…Whether nutritional supplementation could improve sarcopenic status and improve prognoses, however, requires further investigation. Second, proinflammatory mediators such as tumor necrosis factor-α and interleukin-6 play a pivotal role in the development and progression of sarcopenia ( 38 ). Some studies have shown that systemic inflammation is related to poor survival in several cancers ( 39 , 40 ), and it is also among the most prominent features of sarcopenia ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of sarcopenia in patients with locally advanced adenocarcinoma of the esophagogastric junction treated with neoadjuvant chemoradiotherapy

Ming

Geng

et al. 2023

Front. Nutr.

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BackgroundFew studies have evaluated the significance of sarcopenia in predicting the outcomes of patients with adenocarcinoma of the esophagogastric junction (AEG), especially those who received neoadjuvant chemoradiotherapy (NCRT). We aimed to identify the sarcopenic status and its impact on the outcomes of patients with locally advanced AEG who received NCRT followed by radical surgery or systemic therapy.Materials and methodsPatients with T3-4N+M0 AEG with accessible abdominal computed tomography (CT) before and after NCRT were retrospectively analyzed. Body composition parameters, particularly the skeletal muscle index (SMI), were assessed using a CT-based method, and sarcopenia was defined using a predetermined SMI cutoff value. Survival analysis was conducted using the Kaplan–Meier method. A Cox proportional hazards regression model was used to identify independent prognostic factors. Receiver operating characteristic curve analysis was carried out, and the area under the curve (AUC) was calculated to test the prognostic accuracy of different factors.ResultsA total of 63 patients were enrolled, 65.1 and 79.4% of whom developed pre- and post-NCRT sarcopenia, respectively. Patients with pre-NCRT sarcopenia had lower radical surgery rates (70.7 vs. 95.5%, p = 0.047) than those without sarcopenia; however, sarcopenic status did not affect other short-term outcomes, including treatment-related toxicity and efficacy. Pre-NCRT sarcopenia was identified as an independent predictive factor for poor overall survival (OS) [adjusted hazard ratio (HR), 6.053; p = 0.002] and progression-free survival (PFS) (adjusted HR, 2.873; p = 0.031). Compared with nutritional indices such as the Nutritional Risk Screening 2002, weight loss during NCRT, and post-NCRT sarcopenia, pre-NCRT sarcopenia was regarded as the best predictive index for the 5-year OS (AUC = 0.735) and PFS rates (AUC = 0.770).ConclusionPre-NCRT sarcopenia may be an independent predictive factor for OS and PFS rates in patients with locally advanced AEG receiving multimodal treatment.

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Section: Discussionmentioning

confidence: 99%

Prognostic impact of sarcopenia in patients with locally advanced adenocarcinoma of the esophagogastric junction treated with neoadjuvant chemoradiotherapy

Ming

Geng

et al. 2023

Front. Nutr.

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“…The findings of this research align with prior studies, indicating that SMD can serve as a standalone prognostic indicator for patients with MIBC. The loss of skeletal muscle tissue in tumor patients is primarily attributable to the active systemic inflammatory response in tumor patients, the increase in reactive oxygen species, the mitochondrial dysfunction caused by oxidative stress, and the dysfunction of skeletal muscle cells in the tumor microenvironment 25–27 . In addition, skeletal muscle tissue decreases, as does its secretion of antitumor myokines, resulting in a worse prognosis for cancer patients 28 .…”

Section: Discussionmentioning

confidence: 99%

A novel nomogram based on body composition and nutritional indicators to predict the prognosis of patients with muscle‐invasive bladder cancer undergoing radical cystectomy

Zhong,

Pan,

et al. 2023

Cancer Medicine

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ObjectiveTo investigate the prognostic significance of body composition and nutritional indicators in patients undergoing radical cystectomy with muscle‐invasive bladder cancer (MIBC) and to develop a novel nomogram that accurately predicts overall survival (OS).MethodsFrom December 2010 to December 2020, we retrospectively collected clinical and pathological data from 373 MIBC patients who underwent radical cystectomy at our hospital. Preoperative computed tomography (CT) images were used to measure the skeletal muscle index (SMI), subcutaneous adipose index (SAI), visceral adipose index (VAI), skeletal muscle density (SMD), subcutaneous adipose density (SAD), visceral adipose density (VAD), and visceral adipose to subcutaneous adipose area ratio (VSR). The clinicopathological characteristics were evaluated using LASSO regression and multivariate Cox regression, and a nomogram was constructed to predict 1‐, 3‐, and 5‐year overall survival. The concordance index (C‐index), time‐dependent receiver operating characteristic curves (t‐ROC), calibration curve, and decision curve analysis (DCA) were used to assess the discriminative ability, calibration, and clinical practicality of the nomogram.ResultsMultivariate analyses demonstrated that pT stage, lymph node status, LVI, SMD, and prognostic nutritional index (PNI) are independent prognostic factors for OS. Additionally, a nomogram was created. The nomogram's C‐index was 0.714 (95% CI: 0.695–0.733). The area under the t‐ROC curve of 1‐, 3‐, and 5‐year survival corresponding to the model was 0.726, 0.788, and 0.785, respectively. The calibration curve demonstrated excellent agreement between the predicted and observed outcomes. The DCA revealed that patients with MIBC could benefit from the nomogram.ConclusionBased on body composition and nutritional indicators, we developed a novel nomogram with excellent predictive accuracy and reliability for predicting the prognosis of MIBC patients undergoing RC.

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“…Sarcopenia and malnutrition often occur in the context of cancer and are also usually predictive of a poor prognosis ( 45 ). Therefore, detailed evaluation and regular monitoring of sarcopenia in the context of cancer is necessary.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia in Patients With Spinal Metastasis: A Systematic Review and Meta-Analysis of Retrospective Cohort Studies

Tan

Gao

et al. 2022

Front. Oncol.

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BackgroundAs a metastasis cancer that happens up to 70% of the cancer patients, spinal metastasis is drawing attention for its significant impairment to health. There exist several predictive models designed to estimate mortality in spinal metastasis patients but they are reported with limited accuracy. In recent years, some retrospective cohort studies have been carried out to associate sarcopenia with mortality in spinal metastasis.IntroductionAs a risk factor leading to adverse events in many diseases, sarcopenia was considered to significantly impact on patients with spinal metastasis in mortality by some scientists. We aimed to look through the current evidence and use statistic measures to value the role of sarcopenia in spinal metastasis. In this study, we are going to perform a systematic review and meta-analysis of available retrospective cohort studies where sarcopenia is assessed for outcomes in spinal metastasis patients.MethodsOn October 7, 2021, we performed a search in PubMed, Embase, and the Cochrane Library. We set no restrictions on language, date or areas. Results were expressed as hazard ratio (HR) or odds ratio (OR) with 95% CI by random effects model. Sensitivity analyses were performed to explore sources of heterogeneity and stability of results.ResultsOf the 4,196 papers screened, 10 retrospective cohort studies were included, with a total of 1,674 patients. Results showed that sarcopenia was associated with higher overall mortality (OR, 1.60; 95% CI 1.35–1.90) and lower overall survival (HR, 2.08; 95% CI 1.55–2.80). The sensitivity analysis proved the stability of results in terms of publication years, region, time of diagnosis, sample size, female rate, measurement and follow up period.ConclusionsSarcopenia is a robust indicator of mortality in spinal metastasis patients and it might be applied to decision-making tools to assess survival probability and adjust the extent of treatment, while a lack of higher level of evidence is existing.Systematic Review RegistrationPROSPERO CRD42021283348.

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Sarcopenia versus cancer cachexia: the muscle wasting continuum in healthy and diseased aging

Cited by 13 publications

References 183 publications

Prognostic impact of sarcopenia in patients with locally advanced adenocarcinoma of the esophagogastric junction treated with neoadjuvant chemoradiotherapy

Prognostic impact of sarcopenia in patients with locally advanced adenocarcinoma of the esophagogastric junction treated with neoadjuvant chemoradiotherapy

A novel nomogram based on body composition and nutritional indicators to predict the prognosis of patients with muscle‐invasive bladder cancer undergoing radical cystectomy

Sarcopenia in Patients With Spinal Metastasis: A Systematic Review and Meta-Analysis of Retrospective Cohort Studies

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