Impact of sarcopenia on clinical outcome in old patients with cancer [thesis]

Lindsey Otten, Universitätsbibliothek Der FU Berlin, Universitätsbibliothek Der FU Berlin
2020
Introduction and background: Sarcopenia was originally defined as the age-related loss of muscle mass. In addition to primary, or age-related sarcopenia, secondary sarcopenia describes muscle depletion due to physical inactivity, inadequate nutrition or disease. Therefore, particularly older patients with chronic disease, for example cancer, are at an increased risk of developing sarcopenia. In addition to the physiological age-related changes, older patients with cancer are burdened by the
more » ... ical and metabolic effects of the cancer disease itself as well as its treatment. Loss of muscle mass leads to functional impairment, reduced quality of life and poor clinical outcome. This study aimed to assess the prevalence of sarcopenia in older patients with cancer and its impact on 1-year mortality. Methods: Sarcopenia was defined as suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as low skeletal muscle mass index and muscle strength assessed by bioelectric impedance analysis and isometric hand grip strength, respectively. Information on one-year mortality was collected by telephone follow-up or by contacting the local cancer death registry. A step-wise, forward Cox proportional hazards analysis was performed to identify risk factors of 1-year mortality. Results: Four-hundred thirty-nine older patients with cancer were included in the analysis (60-95 years; 43.5% women), of which 119 (27.1%) were identified as sarcopenic. Sixty-two (52.5%) of the patients with sarcopenia compared to 108 (35.1%) without sarcopenia died within one year of study entry. Patients without sarcopenia had longer survival times (291.2 days, 95% CI: 278.0-304.5 versus 244.0 days, 95% CI: 219.2-268.7, p<0.001). Advanced tumour stage IV (HR=1.87; 95% CI: 1.228-2.847; p=0.004), sarcopenia (HR=1.53; 95% CI: 1.034-2.250; p=0.033), number of drugs per day (HR=1.11; 95% CI: 1.057-1.170; p<0.001), Karnofsky Index (HR=0.98, 95% CI: 0.963-0.995; p=0.013) and tumour diagnosis (overall p=0.012) were significantly assoc [...]
doi:10.17169/refubium-27040 fatcat:legvndfzq5cdjja7e5otzj4jta