The influence of different muscle mass measurements on the diagnosis of cancer cachexia

Blauwhoff‐Buskermolen, Susanne; Langius, J.A.E.; Becker, Annemarie; Verheul, Henk M.W.; Schueren, Marian A.E. de van der

doi:10.1002/jcsm.12200

Cited by 63 publications

(73 citation statements)

References 31 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors suggested including CRP (>10 mg/L) and appetite loss to better define pre‐CAX. A study by Blauwhoff‐Buskermolen et al ., however, showed that this definition identified very few pre‐CAX patients . Vigano et al .…”

Section: Discussionmentioning

confidence: 97%

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Antoun

Morel

Souquet

et al. 2019

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

Background An international consensus proposed in 2011 a definition and classification system for cachexia (CAX), mainly based on weight loss, sarcopenia [skeletal muscle mass (SMM) loss], inflammation, and anorexia. The aim of this study was to stage CAX in non‐small‐cell lung cancer (NSCLC) patients by using a classification based on the Fearon criteria and supported by quantifiable parameters. Methods This was a cross‐sectional and non‐interventional multicentre study. SMM was assessed by analysing L3 computed tomography‐scan images. Patients completed the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy, EORTC QLQ‐C30 quality of life (QoL) and International Physical Activity Questionnaire (IPAQ). Results Patients were recruited in 56 sites. The analysis population comprised 531 patients, and SMM was assessed in 312 patients. Male patients were 66.5%, with a mean (SD) age of 65.2 (10.0) years, 79.9% were PS 0–1, and the tumour stage was mainly IIIB‐IV (87.3%). Overall, 38.7% of patients had CAX, 33.8% pre‐CAX, and 0.9% refractory CAX. Molecular tumour profiles were significantly associated with the presence of CAX: 23.9% in EGFR, ALK, ROS1, BRAF, or HER2+ patients, 41.4% in K‐RAS+, and 43.2% in patients with no molecular abnormality ( P = 0.003). The more advanced the CAX stage, the poorer the scores of functional items of the QoL ( P < 0.001) and International Physical Activity Questionnaire ( P < 0.001). Sarcopenia was present in 66.7% of CAX and 68.5% of pre‐CAX patients. Overall, 43.8% of pre‐CAX patients had only sarcopenia with limited weight loss (≤2%) and no anorexia. Conclusions This is the first study to show the distribution of CAX in a population of NSCLC patients and an association between molecular abnormality in NSCLC and CAX. The original Fearon classification for CAX stages was supported by the associated functional QoL scores and physical activity levels, resulting in a clinically relevant system for detection of early stages of CAX.

show abstract

Section: Discussionmentioning

confidence: 97%

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Antoun

Morel

Souquet

et al. 2019

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

show abstract

“…49 It is important to highlight that different instruments in literature for assessing loss of muscle mass can produce a relative variability in frequency of sarcopenia and cachexia, and there are multiple methods of adjusting the result for height or for BMI. 50 Recently, Blauwhoff-Buskermolen et al 51 found a large variation of prevalence of low muscle mass (13% to 93%) with different techniques (anthropometry, CT, and bioelectrical impedance) in cancer patients, and it has repercussion in diagnosis of cachexia and sarcopenia. However, despite a large disagreement between muscle measures in identifying a low muscle mass in these patients, the effect on the diagnosis of cancer cachexia was limited.…”

Section: Discussionmentioning

confidence: 99%

Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? A prospective study

Rocha

Marcadenti

Medeiros

et al. 2019

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

Background Chemotherapy is an effective treatment with good clinical response in patients with cancer. However, it can cause exacerbated toxicities in patients and consequently change the course of treatment. Some factors may interfere with this toxicity such as body composition, especially in gastrointestinal cancer. The aim of this study was to evaluate the effects of body composition, nutritional status, and functional capacity scale in predicting the occurrence of toxicities in gastrointestinal cancer patients during chemotherapy treatment. Methods This is a prospective study with gastrointestinal cancer patients at the beginning of chemotherapy treatment. Sarcopenia and muscle attenuation were assessed using the skeletal muscle index from computerized tomography by measuring cross‐sectional areas of the L3 tissue (cm 2 /m 2 ). Cachexia was graded according to involuntary weight loss associated with sarcopenia. Nutritional status was assessed by using anthropometric evaluation and Patient‐Generated Subjective Global Assessment. Functional capacity was evaluated by handgrip strength and Eastern Cooperative Oncology Group (ECOG) Performance Status scale. Haematological gastrointestinal and dose‐limiting toxicities (DLTs) were defined according to National Cancer Institute Common Toxicity Criteria. The associations among sarcopenia, cachexia, nutritional status, and functional capacity with DLT were assessed by univariate and multivariate Cox regression model. Results A total of 60 patients were evaluated (55% male, 60.9 ± 14.0 years) and followed up for a mean of 55 days. Most patients had normal weight (44.2%) and good ECOG Performance Status (≤1) at baseline (78%). During the chemotherapy period, the most prevalent toxicities were diarrhoea, nausea, and anorexia, but the presence of DLT was similar between cycles ( P > 0.05). Cachexia was associated with a higher toxicity manifested by diarrhoea ( P = 0.02), nausea ( P = 0.02), and anorexia ( P < 0.01 and P = 0.03 at Cycles 1 and 2, respectively). Sarcopenic and cachetic individuals experienced more toxicities and DLT during chemotherapy. The only factors associated with DLT in the multivariate Cox regression analyses including the presence of metastasis and the chemotherapy protocol were cachexia and the ECOG scale ( P < 0.001 for both). Conclusions Cachexia and ECOG score may identify patients with an increased risk for developing severe toxicity events during chemotherapy treatment for gastrointestinal cancer.

show abstract

“…Definitions of a low muscle mass that are based on different methods therefore differ between guidelines from the European Group on Sarcopenia in Older People and the International Consensus for Cancer Cachexia [23]. The prevalence of low muscle mass in patients with cancer may depend on the method of muscle measurement [24]. Using the seca mBCA 515 device, the prediction of SMM has advantages over the prediction of FFM because the pure error in comparison to MRI is smaller for the corrected SMM equation than for SMM calculated from corrected FFM (1.41 vs. 1.50 kg for all and 2.09 vs. 2.14 kg for obese subjects).…”

Section: Discussionmentioning

confidence: 99%

Limitations of Fat-Free Mass for the Assessment of Muscle Mass in Obesity

Jensen¹,

Braun²,

Geisler³

et al. 2019

Obes Facts

View full text Add to dashboard Cite

Background: A high amount of adipose tissue limits the accuracy of methods for body composition analysis in obesity. Objectives: The aim was to quantify and explain differences in fat-free mass (FFM) (as an index of skeletal muscle mass, SMM) measured with bioelectrical impedance analysis (BIA), dual energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), and deuterium dilution in comparison to multicompartment models, and to improve the results of BIA for obese subjects. Methods: In 175 healthy subjects (87 men and 88 women, BMI 20–43.3 kg/m2, 18–65 years), FFM measured by these methods was compared with results from a 3- (3C) and a 4-compartment (4C) model. FFM4C was compared with SMM measured by magnetic resonance imaging. Results: BIA and DXA overestimated and ADP underestimated FFM in comparison to 3C and 4C models with increasing BMI (all p < 0.001). Differences were largest for DXA. In obesity, BIA results were improved: valuecorrected = valueuncorrected – a(BMI – 30 kg/m2), a = 0.256 for FFM and a = 0.298 for SMM. SMM accounts for 45% of FFM in women and 49% in men. Conclusions: In obesity, the use of FFM is limited by a systematic error of reference methods. In addition, SMM accounts for about 50% of FFM only. Corrected measurement of SMM by BIA can overcome these drawbacks.

show abstract

The influence of different muscle mass measurements on the diagnosis of cancer cachexia

Cited by 63 publications

References 31 publications

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Is cachexia associated with chemotherapy toxicities in gastrointestinal cancer patients? A prospective study

Limitations of Fat-Free Mass for the Assessment of Muscle Mass in Obesity

Contact Info

Product

Resources

About