Sarcopenia prevalence in patients with cancer and association with adverse prognosis: A nationwide survey on common cancers

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 114; p. 112107
• Main Authors: Zhang, Feng-Min, Song, Chun-Hua, Guo, Zeng-Qing, Yu, Zhen, Weng, Min, Zhou, Fu-Xiang, Liu, Ming, Cong, Ming-Hua, Li, Tao, Li, Zeng-Ning, Chen, Jun-Qiang, Cui, Jiu-Wei, Xu, Hong-Xia, Li, Wei, Shi, Han-Ping, Zhuang, Cheng-Le
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2023; Elsevier Limited
• Subjects: Age; Aging; Anemia; Body mass index; Body size; Breast cancer; Cancer; Chi-square test; Clinical outcomes; cohort studies; death; Esophagus; Food; Gait; hazard ratio; Hemoglobin; Medical prognosis; Morality; Mortality; Mortality risk; Muscle; Musculoskeletal system; national surveys; Neutrophils; Nutritional status; Observational studies; Ovarian cancer; Patients; prediction; Prediction models; Prognosis; Quality of life; Regression analysis; Risk factors; Sarcopenia; Skeletal muscle; Statistical analysis; Womens health; United States > US; Aging; Sarcopenia; Muscle; Morality; Cancer
• ISSN: 0899-9007; 1873-1244; 1873-1244
• DOI: 10.1016/j.nut.2023.112107

•Age is the most important risk factor for sarcopenia.•Patients with cancer and sarcopenia had a significantly higher and earlier peak risk for mortality.•Sarcopenia was independently associated with mortality in the total population (hazard ratio, 1.429, P < 0.001) and most cancer types.•This was the first study to explore the prognostic effect of sarcopenia in a pan-cancer and large-scale population.•Hazard function is used to reveal the effects of sarcopenia on cancer death overtime in patients with cancer.•This study emphasized the adverse effects of sarcopenia and offered the possibility of using clinical prediction models to aid in the rapid diagnosis of sarcopenia. Although previous studies have implicated the negative outcomes of sarcopenia, evidence is limited to one or a few types of cancer. The aim of this study was to evaluate the distribution and influencing factors of sarcopenia, and explore the relationship between sarcopenia and cancer prognosis in a large oncological population. This observational cohort study included patients diagnosed with malignant cancer between May 2011 and January 2019. Hematologic and anthropometric parameters were collected prospectively. Low skeletal muscle mass and radiodensity were diagnosed using clinical indicators, according to the two prediction models. The importance of potential risk factors for sarcopenia was estimated by subtracting the predicted degrees of freedom from the partial χ2 statistic. Hazard rates of death were calculated using the hazard function and Cox regression analyses. We included 13 761 patients with cancer; the prevalence of sarcopenia was 33%. The median age was 58 y and 7135 patients (52%) were men. Patients with sarcopenia had a worse nutritional status and quality of life than those without sarcopenia. Age was the most important risk factor for sarcopenia compared with body mass index or TNM stage. Additionally, patients with sarcopenia had a significantly higher and earlier peak risk for mortality. After adjusting for baseline characteristics, sarcopenia was independently associated with mortality in the research population (hazard ratio, 1.429; P < 0.001) and most cancer types. Age is the most important risk factor for sarcopenia even in patients with cancer. Sarcopenia is strongly associated with a poor quality of life and reduced overall survival.