Loss of skeletal muscle mass during palliative chemotherapy is a poor prognostic factor in patients with advanced gastric cancer

Abstract Cancer causes muscle mass loss, which is associated with a poor prognosis. Chemotherapy may also reduce muscle mass. We investigated skeletal muscle mass change during palliative chemotherapy for advanced gastric cancer (AGC) and its association with treatment outcomes. We retrospectively reviewed 111 consecutive AGC patients who underwent first-line palliative chemotherapy. Skeletal muscle area was measured before and after chemotherapy at the third lumbar vertebra level using computed tomography scans. We compared skeletal muscle index (SMI), body mass index (BMI), and body weight changes to chemotherapy response and survival. The 80 male and 31 female patients’ median age was 65 (range 31–87) years, and 46.8% had sarcopenia at baseline. Median pre-chemotherapy to post-chemotherapy SMI, BMI, and body weight decreases were − 4.5 cm2/m2 (− 11.3%) (P < 0.001); − 0.7 kg/m2 (− 3.2%) (P < 0.001); and − 2.0 kg (− 3.5%) (P < 0.001), respectively. Median SMI decreases for patients with objective response, stable disease, and disease progression were − 4.0 cm2/m2 (range − 20.1 ~ 9.5); − 4.5 cm2/m2 (range − 19.8 ~ 0.8); and − 3.8 cm2/m2 (range: − 17.6 ~ 0.1), respectively. Response to chemotherapy was not associated with SMI decrease (P = 0.463). In multivariable analysis, sarcopenia at baseline (HR 1.681; 95% CI 1.083–2.609, P = 0.021), decreased SMI (HR 1.620; 95% CI 1.041–2.520; P = 0.032) were significant poor prognostic factors for survival. Skeletal muscle mass decreased significantly during chemotherapy in AGC patients, but was not associated with chemotherapy response. Decreased SMI was a poor prognostic factor in AGC patients during first-line palliative chemotherapy.

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Loss of skeletal muscle mass during palliative chemotherapy is a poor prognostic factor in patients with advanced gastric cancer

Annals of Oncology ◽

10.1093/annonc/mdz265.027 ◽

2019 ◽

Vol 30 ◽

pp. v727

Author(s):

I.G. Hwang ◽

S.E. Park ◽

S.-C. Lee ◽

J.H. Choi

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Prognostic Factor ◽

Advanced Gastric Cancer ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Palliative Chemotherapy ◽

Poor Prognostic Factor

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CHANGES OF SKELETAL MUSCLE MASS DURING PALLIATIVE CHEMOTHERAPY IN OLDER PATIENTS WITH ADVANCED GASTRIC CANCER

Journal of Geriatric Oncology ◽

10.1016/s1879-4068(19)31245-7 ◽

2019 ◽

Vol 10 (6) ◽

pp. S76

Author(s):

I. Hwang ◽

S. Park ◽

J. Choi

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Advanced Gastric Cancer ◽

Muscle Mass ◽

Older Patients ◽

Skeletal Muscle Mass ◽

Palliative Chemotherapy

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Impact of skeletal muscle mass in patients with unresectable gastric cancer who received palliative first-line chemotherapy based on 5-fluorouracil

BMC Cancer ◽

10.1186/s12885-021-08953-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tomoyuki Matsunaga ◽

Hiroaki Saito ◽

Wataru Miyauchi ◽

Yuji Shishido ◽

Kozo Miyatani ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Side Effects ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Palliative Chemotherapy ◽

Inflammatory Factors ◽

Unresectable Gastric Cancer ◽

Grade 3 ◽

Line Chemotherapy

Abstract Background The mortality rate of patients with unresectable gastric cancer (UGC) has decreased with the development of chemotherapies and surgical techniques. However, the survival rate remains low. We retrospectively examined the prognostic significance of the pretreatment skeletal muscle mass index (SMI) and nutritional and inflammatory factors in patients with UGC. Methods This study included 83 patients diagnosed with UGC at Tottori University Hospital who received palliative chemotherapy based on 5-fluorouracil. Pretreatment computed tomography (CT) measured overall skeletal muscle mass (SMM) and cross-sectional SMM at the third lumbar vertebra (L3). We focused on the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein-to-albumin ratio (CAR), prognostic nutritional index (PNI), and platelet-to-lymphocyte ratio (PLR) as nutritional and inflammatory factors. Results Receiver operating characteristic curve analysis was performed for median survival time (MST) after palliative chemotherapy. SMIs for males and females (43.9 cm2/m2 and 34.7 cm2/m2, respectively) were the cutoff values, and patients were divided into high (SMIHigh; n = 41) and low SMI groups (SMILow; n = 42). Body mass index (BMI) was significantly higher in patients in the SMIHigh group than in the SMILow group (p < 0.001). The number of patients who received third-line chemotherapy was significantly higher in the SMIHigh group than in the SMILow group (p = 0.037). The MST was significantly higher in the SMIHigh group than in the SMILow group (17.3 vs. 13.8 months; p = 0.008). The incidence of grade 3 or 4 side effects was significantly higher in patients with SMILow UGC (p = 0.028). NLR was significantly higher in patients with SMILow than it was in those with SMIHigh. (p = 0.047). In the univariate analysis, performance status, SMI, histological type, lines of chemotherapy, and NLR were prognostic indicators. The multivariate analysis identified SMI (p = 0.037), NLR (p = 0.002), and lines of chemotherapy (p < 0.001) as independent prognostic factors. Conclusions The SMILow group had significantly more grade 3 or 4 side effects, were related to high NLR, and had a significantly worse prognosis than the SMIHigh group. Trial registration Retrospectively registerd.

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Low Skeletal Muscle Mass before Salvage-Line Chemotherapy Is a Poor Prognostic Factor in Patients with Refractory Metastatic Colorectal Cancer

Digestion ◽

10.1159/000494417 ◽

2018 ◽

Vol 99 (1) ◽

pp. 79-85 ◽

Cited By ~ 2

Author(s):

Yuji Miyamoto ◽

Yukiharu Hiyoshi ◽

Takahiko Akiyama ◽

Yuki Kiyozumi ◽

Kojiro Eto ◽

...

Keyword(s):

Colorectal Cancer ◽

Skeletal Muscle ◽

Prognostic Factor ◽

Metastatic Colorectal Cancer ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Poor Prognostic Factor ◽

Line Chemotherapy

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Loss of skeletal muscle mass after curative gastrectomy is a poor prognostic factor

Oncology Letters ◽

10.3892/ol.2018.8747 ◽

2018 ◽

Cited By ~ 2

Author(s):

Naruji Kugimiya ◽

Eijiro Harada ◽

Kazuhito Oka ◽

Daichi Kawamura ◽

Yuki Suehiro ◽

...

Keyword(s):

Skeletal Muscle ◽

Prognostic Factor ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Curative Gastrectomy ◽

Poor Prognostic Factor

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Skeletal muscle mass is associated with erythropoietin response in hemodialysis patients

BMC Nephrology ◽

10.1186/s12882-021-02346-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Tomoaki Takata ◽

Yukari Mae ◽

Kentaro Yamada ◽

Sosuke Taniguchi ◽

Shintaro Hamada ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Weight ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Linear Regression Analysis ◽

Transferrin Saturation ◽

Resistance Index ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Weekly Dose

Abstract Background Hyporesponsiveness to erythropoietin stimulating agent (ESA) is associated with poor outcomes in patients with chronic kidney disease. Although ESA hyporesponsiveness and sarcopenia have a common pathophysiological background, clinical evidence linking them is scarce. The purpose of the study was to investigate the relationship between ESA responsiveness and skeletal muscle mass in hemodialysis patients. Methods This cross-sectional study analyzed 70 patients on maintenance hemodialysis who were treated with ESA. ESA responsiveness was evaluated by erythropoietin resistance index (ERI), calculated as a weekly dose of ESA divided by body weight and hemoglobin (IU/kg/week/dL), and a weekly dose of ESA/hemoglobin (IU/week/dL). A dose of ESA is equivalated to epoetin β. Correlations between ESA responsiveness and clinical parameters including skeletal muscle mass were analyzed. Results Among the 70 patients, ERI was positively correlated to age (p < 0.002) and negatively correlated to height (p < 0.001), body weight (p < 0.001), BMI (p < 0.001), skeletal muscle mass (p < 0.001), transferrin saturation (TSAT) (p = 0.049), and zinc (p = 0.006). In the multiple linear regression analysis, TSAT, zinc, and skeletal muscle mass were associated with ERI and weekly ESA dose/hemoglobin. Conclusions Skeletal muscle mass was the independent predictor for ESA responsiveness as well as TSAT and zinc. Sarcopenia is another target for the management of anemia in patients with hemodialysis.

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SUN-LB007: Reduced Appendicular Skeletal Muscle Mass Presented by the Asian Working Group for Sarcopenia is a Poor Prognostic Factor of Chronic Heart Failure Patients

Clinical Nutrition ◽

10.1016/s0261-5614(15)30728-7 ◽

2015 ◽

Vol 34 ◽

pp. S237

Author(s):

N. Suzuki ◽

K. Kida ◽

K. Ashikaga ◽

K. Suzuki ◽

Y. Kasahara ◽

...

Keyword(s):

Heart Failure ◽

Skeletal Muscle ◽

Chronic Heart Failure ◽

Prognostic Factor ◽

Working Group ◽

Skeletal Muscle Mass ◽

Poor Prognostic Factor ◽

Heart Failure Patients ◽

Appendicular Skeletal Muscle ◽

Appendicular Skeletal Muscle Mass

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Body composition and energy intake — skeletal muscle mass is the strongest predictor of food intake in obese adolescents: The HEARTY trial

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2015-0479 ◽

2016 ◽

Vol 41 (6) ◽

pp. 611-617 ◽

Cited By ~ 37

Author(s):

Jameason D. Cameron ◽

Ronald J. Sigal ◽

Glen P. Kenny ◽

Angela S. Alberga ◽

Denis Prud’homme ◽

...

Keyword(s):

Skeletal Muscle ◽

Body Composition ◽

Body Weight ◽

Muscle Mass ◽

Energy Intake ◽

Skeletal Muscle Mass ◽

Fat Free Mass ◽

Cross Sectional ◽

Percentage Body Fat ◽

Obese Adolescents

There has been renewed interest in examining the relationship between specific components of energy expenditure and the overall influence on energy intake (EI). The purpose of this cross-sectional analysis was to determine the strongest metabolic and anthropometric predictors of EI. It was hypothesized that resting metabolic rate (RMR) and skeletal muscle mass would be the strongest predictors of EI in a sample of overweight and obese adolescents. 304 post-pubertal adolescents (91 boys, 213 girls) aged 16.1 (±1.4) years with body mass index at or above the 95th percentile for age and sex OR at or above the 85th percentile plus an additional diabetes risk factor were measured for body weight, RMR (kcal/day) by indirect calorimetry, body composition by magnetic resonance imaging (fat free mass (FFM), skeletal muscle mass, fat mass (FM), and percentage body fat), and EI (kcal/day) using 3 day food records. Body weight, RMR, FFM, skeletal muscle mass, and FM were all significantly correlated with EI (p < 0.005). After adjusting the model for age, sex, height, and physical activity, only FFM (β = 21.9, p = 0.007) and skeletal muscle mass (β = 25.8, p = 0.02) remained as significant predictors of EI. FFM and skeletal muscle mass also predicted dietary protein and fat intake (p < 0.05), but not carbohydrate intake. In conclusion, with skeletal muscle mass being the best predictor of EI, our results support the hypothesis that the magnitude of the body’s lean tissue is related to absolute levels of EI in a sample of inactive adolescents with obesity.

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