Clinical significance of sarcopenia in children with neuroblastic tumors

• Published in: Pediatric surgery international Vol. 40; no. 1; p. 237
• Main Authors: Kudo, Wataru, Terui, Keita, Furugane, Ryoya, Takenouchi, Ayako, Komatsu, Shugo, Kawaguchi, Yunosuke, Nishimura, Katsuhiro, Katsumi, Daisuke, Hishiki, Tomoro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 21.08.2024; Springer Nature B.V
• Subjects: Body Mass Index; Child; Child, Preschool; Clinical Relevance; Clinical significance; Female; Follow-Up Studies; Humans; Infant; Male; Medicine; Medicine & Public Health; Neuroblastoma - complications; Neuroblastoma - diagnostic imaging; Original; Original Article; Pediatric Surgery; Pediatrics; Prognosis; Retrospective Studies; Sarcopenia; Sarcopenia - complications; Sarcopenia - diagnostic imaging; Sarcopenia - epidemiology; Surgery; Tomography, X-Ray Computed - methods; Skeletal muscle index; Sarcopenia; Neuroblastic tumor; Growth impairment
• ISSN: 0179-0358; 1437-9813; 1437-9813
• DOI: 10.1007/s00383-024-05815-9

Purpose To elucidate the clinical significance of sarcopenia in children with neuroblastic tumors (NTs). Methods We conducted a retrospective observational study and analyzed the z-scores for height, body weight, body mass index, and skeletal muscle index (HT-z, BW-z, BMI-z, and SMI-z) along with the clinical characteristics of 36 children with NTs. SMI-z was calculated from 138 computed tomography scans at diagnosis, during treatment, and at follow-up. The International Neuroblastoma Risk Group classification was used to identify high-risk groups. We analyzed the data at diagnosis for prognostic analysis and changes over time after diagnosis in the HT-z, BW-z, BMI-z, and SMI-z groups. Results Among the four parameters at diagnosis, only SMI-z predicted overall survival (hazard ratio, 0.58; 95% confidence interval, 0.34–0.99). SMI-z, HT-z, and BW-z significantly decreased over time after diagnosis ( P  < 0.05), while BMI-z did not ( P  = 0.11). In surviving high-risk NT cases without disease, SMI-z, HT-z, and BW-z significantly decreased over time ( P  < 0.05), while BMI-z did not ( P  = 0.43). Conclusion In children with NT, the SMI-z at diagnosis was a significant prognostic factor and decreased during treatment and follow-up along with HT-z and BW-z. Monitoring muscle mass is important because sarcopenia may be associated with growth impairment.