Association between pretherapeutic M2BPGi levels and postoperative skeletal muscle depletion in patients with esophageal squamous cell carcinoma.

Effect of loop diuretics on skeletal muscle depletion in patients with liver cirrhosis

The association of changes in skeletal muscle mass and quality during the waiting time with outcomes of lung transplantation (LT) remains unclear. We aimed to examine the association of changes in skeletal muscle mass and quality during the waiting time, as well as preoperative skeletal muscle mass and quality, with outcomes of LT. This study included individuals who underwent LT from brain-dead donors. Skeletal muscle mass (cm2 /m2 ) and quality (mean Hounsfield units [HU]) of the erector spinae muscle at the 12th thoracic level were evaluated using computed tomography. Preoperative skeletal muscle mass and quality, and their changes during the waiting time were calculated. We evaluated the associations among mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, 6-minute walk distance at discharge, and 5-year survival after LT. This study included 98 patients. The median waiting time was 594.5days (interquartile range [IQR], 355.0-913.0). The median changes in skeletal muscle mass and quality were -4.4% (IQR, -13.3-3.1) and -2.9% (IQR, -16.0-4.1), respectively. Severe low skeletal muscle mass at LT was associated with prolonged ICU LOS (B=8.46, 95% confidence interval [CI]: .51-16.42) and hospital LOS (B=36.00, 95% CI: 3.23-68.78). Pronounced decrease in skeletal muscle mass during the waiting time was associated with prolonged MV duration (B=7.85, 95% CI: .89-14.81) and ICU LOS (B=7.97, 95% CI: .83-15.10). Maintaining or increasing skeletal muscle mass during the waiting time would be beneficial to improve the short-term outcomes of LT.

Influence of Lower Limb Ischemia on Skeletal Muscle Mass Depletion in Patients with Peripheral Artery Disease

AimA decrease in skeletal muscle mass in patients with gastric cancer following surgery is closely related to tumor recurrence and poor prognosis. Postoperative enteral nutrition support can accelerate the postoperative recovery of patients with gastric cancer. We aimed to analyze the effectiveness of short-term oral nutritional supplements(ONS) in attenuating postoperative skeletal muscle mass loss in gastric cancer patients after hospital discharge and the impact on long-term prognosis.MethodsThis study included patients who underwent radical gastrectomy at our center between 2014 and 2019. Univariate and multivariate logistic regression analyses were used to analyze the effectiveness of short-term oral nutrition for reducing postoperative skeletal muscle mass loss in patients with gastric cancer. Using cox regression to analyze the effect of ONS and each covariate on overall survival (OS).ResultsONS attenuated postoperative skeletal muscle loss, and it can improve the prognosis of patients, especially the elderly, those with poor nutritional status, anemia, and patients who have undergone total gastrectomy.ConclusionsShort-term oral nutrition is an independent protective factor for preventing skeletal muscle mass loss in patients with gastric cancer after surgery. Oral nutrition after surgery can reduce short-term muscle mass loss and is helpful in lowering the risk of death for patients.

Quantifying the severity of sarcopenia in patients with cancer of the head and neck

We employed a whole body magnetic resonance imaging protocol to examine the influence of age, gender, body weight, and height on skeletal muscle (SM) mass and distribution in a large and heterogeneous sample of 468 men and women. Men had significantly (P < 0.001) more SM in comparison to women in both absolute terms (33.0 vs. 21.0 kg) and relative to body mass (38.4 vs. 30.6%). The gender differences were greater in the upper (40%) than lower (33%) body (P < 0.01). We observed a reduction in relative SM mass starting in the third decade; however, a noticeable decrease in absolute SM mass was not observed until the end of the fifth decade. This decrease was primarily attributed to a decrease in lower body SM. Weight and height explained approximately 50% of the variance in SM mass in men and women. Although a linear relationship existed between SM and height, the relationship between SM and body weight was curvilinear because the contribution of SM to weight gain decreased with increasing body weight. These findings indicate that men have more SM than women and that these gender differences are greater in the upper body. Independent of gender, aging is associated with a decrease in SM mass that is explained, in large measure, by a decrease in lower body SM occurring after the fifth decade.

Skeletal muscle depletion (sarcopenia) is closely associated with limited physical ability and high mortality. This study was performed to evaluate the prognostic significance of skeletal muscle depletion in patients with resectable stage I-III colorectal cancer (CRC). We conducted a retrospective analysis of 220 consecutive patients with stage I-III CRC who underwent curative resection. The skeletal muscle cross-sectional area was measured by preoperative computed tomography. The lowest sex-specific quartile of skeletal muscle mass was classified as sarcopenia. Factors contributing to recurrence-free survival (RFS) were analyzed by univariate and multivariate Cox proportional hazard models. Of 220 patients who met our inclusion criteria, 55 (25%) had sarcopenia. The median follow-up duration was 41.4months. Patients with sarcopenia were younger and had higher carcinoembryonic antigen levels than patients without sarcopenia. RFS and overall survival (OS) were significantly shorter in patients with sarcopenia than those without (5-year RFS, 56 vs. 79%, log-rank p=0.006; 5-year OS, 68 vs. 85%, log-rank p=0.015). Multivariate Cox regression analysis revealed that sarcopenia was independently associated with shorter RFS (hazard ratio [HR] 2.176; 95% confidence interval [CI] 1.200-3.943; p=0.010) and OS (HR 2.270; 95% CI 1.147-4.494; p=0.019). The influence of sarcopenia on patient outcome was modified by age at surgery (p value for interaction=0.026); sarcopenia was associated with a poor prognosis, especially in young patients (log-rank p<0.001). Sarcopenia negatively impacts survival in patients undergoing curative resection for stage I-III CRC.

In recent years, the number of patients with cancer has increased. These patients are prone to sarcopenia as a result of the decrease in muscle mass and muscle weakness that occur in cancer cachexia. Amino Index Cancer Screening is carried out to evaluate cancer cachexia risk by examining amino acid concentration and analyzing amino acid balance. We conducted a retrospective chart review of consecutive patients with unresectable advanced gastrointestinal cancer (stage IV) receiving chemotherapy treatment (December 2012-September 2015) in an outpatient or in-hospital setting at our institution (N = 46). Data included characteristics, psoas muscle area per computed tomography, and biochemical blood test and serum amino acid profiles. Method 1: Comparison of biomarkers between 2 groups: psoas muscle index change rate (ΔPMI) decrease vs increase. Method 2.1: Correlation between ΔPMI and biomarkers. Method 2.2: Multiple regression of ΔPMI and biomarkers. EAA/TAA ratio (essential amino acids/total amino acids) in the decrease group was significantly higher than that in the increase group. Among all parameters, serum C-reactive protein (CRP), leucine, and isoleucine were negatively related to ΔPMI (correlation coefficients = -0.604, -0.540, -0.518; P = .004, .011, .016, respectively). On multiple regression analysis, serum CRP value was strongly related to ΔPMI ( r2 = 0.452, β = -0.672, P = .001). Higher serum EAA/TAA ratio and CRP were associated with depletion in psoas muscle area, which led to a diagnosis of sarcopenia, in patients with advanced gastrointestinal cancers. These parameters at baseline could be predictors of cancer cachexia.

Depletion in skeletal muscle is closely associated with limited physical ability and high mortality. In this study, we evaluated the prognostic significance of skeletal muscle depletion in patients with early-stage non-small-cell lung cancer. A retrospective analysis of patients with pathological stages I-II lung cancer, who underwent curative resection between 2009 and 2013, was conducted. The truncal muscle index (TMI) (area/height2) at the first lumbar vertebral level was measured by preoperative axial computed tomography. Overall survival and recurrence-free survival were compared between the lowest gender-specific quartile of the TMI and the other quartiles. A total of 314 subjects were included in the study. The cumulative 5-year recurrence-free and overall survival rates were significantly shorter in patients with lower TMIs (69% vs 83.5%, P = 0.028; 64.8% vs 80.1%, P = 0.003, respectively). In multivariable models, the TMI was identified as an independent prognostic factor for overall survival (P = 0.017, hazard ratio 1.84, 95% confidence interval 1.12-3.05), after adjusting for age, gender, preoperative serum albumin, carcinoembryonic antigen, neutrophil to lymphocyte ratio and pathological stage. A low preoperative TMI was associated with a poor postoperative outcome in patients with early-stage non-small-cell lung cancer. This factor may be included in the preoperative assessment of patients, for whom surgical intervention is considered.

430. Severe skeletal muscle depletion is associated with reoperation in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

The impact of neoadjuvant chemotherapy on skeletal muscle depletion in patients with resectable colorectal liver metastases

BackgroundSarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis.MethodsWe included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements.ResultsA total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (ΔSMA/y) were −0.89%. During a median follow-up period of 46.2 months (range, 3.4–87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ΔSMA/y were independently associated with mortality. Cumulative mortality was significantly higher in patients with ΔSMA/y < −2.4% than those with ΔSMA/y ≥ −2.4% (log-rank test, P < 0.001).ConclusionBoth the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

ABSTRACTBackgroundAn increasing number of people, including recreational trained individuals, choose not to consume animal products and follow a vegan diet. Young women in particular are switching to a vegan diet. Studies have shown no difference in performance and muscle adaptations between a balanced vegan and an omnivorous diet. However, there are hardly any studies on the transition phase from an omnivorous to a vegan diet and the potential difficulties. Therefore, this study aimed to investigate the influence of a vegan dietary transition and its effects on body composition, physical performance, and menstrual cycle in young, recreationally trained women.MethodsTen young healthy women (23.8 ± 2.0 years, 173.0 ± 5.8 cm) were recruited to participate in this 12-week controlled study (4-week omnivorous phase, 8-week vegan intervention). At the beginning and before the vegan phase, all participants were informed about a balanced diet for fitness-oriented individuals and a vegan lifestyle. They were supervised by a sports dietitian for the entire 12 weeks. Explicit instructions and regular checks on macronutrient distribution were not carried out but had to be implemented independently. The diet was documented using FDDB Extender. The training habits were not explicitly specified, but should not be changed over the entire period. At baseline (T0) and 4-week intervals (T1, T2, T3), body composition (body weight, skeletal muscle mass, fat mass) and performance (squat, countermovement jump) were tested. In addition, the menstrual cycle was examined every two days using saliva samples and a cycle diary.ResultsBetween treatments, there was a significant decrease in absolute (T0: 94.44 ± 20.37 kcal; T3: 71.67 ± 27.64 kcal; p < 0.001) and in relative protein intake (T0: 1.39 ± 0.28 g/kg BW; T3: 1.06 ± 0.37 g/kg BW; p < 0.05). In carbohydrate consumption, a significant increase was observed (T0: 240.11 ± 53.15 kcal; T3: 266.89 ± 49.01 kcal; p < 0.001). During the vegan phase, a significant decrease in body weight (T0: 68.19 ± 6.47 kg, T3: 67.73 ± 6.07 kg; p < 0.001) and skeletal muscle mass (T0: 29.40 ± 2.23 kg; T3: 28.74 ± 2.55 kg; p < 0.001) was observed. No changes were noted in squat performance. The countermovement jump showed a significant decrease in the vegan phase (T0: 26.08 ± 3.44 cm; T3: 23,62 ± 1,00 p < 0.05), but also a significant time effect starting in the omnivorous phase (p < 0.001). No effects were found on hormone concentrations of individual menstrual cycles.ConclusionThe dietary change resulted in a shift in overall macronutrient distribution. Relative protein intake was significantly lower during the vegan phase than during the omnivore phase. This was also observed in a slight decrease in skeletal muscle mass. No clear effects on performance and menstrual cycle were observed during the first eight weeks. The results suggest that despite the knowledge of a balanced diet and in particular the recommendations for a vegan diet, the implementation of a vegan diet in everyday life could be associated with a number of difficulties for recreationally trained women. However, it should be noted that the vegan phase was only conducted for eight weeks and no statement can be made about the long-term effects or on well-trained female athletes.

To assess the change in body composition and hydration status in cyclists in a mountain bike ultra-marathon. Prospective observational field study. "Swiss Bike Masters" 2008 over 120 km with a total climb of 5000 m in altitude. Thirty-seven male mountain bikers. None. Prerace and postrace, body mass, percent body fat, skeletal muscle mass, and selected hematologic and urinary parameters were measured to quantify changes in body mass and hydration status. Athletes reported their fluid intake during the race. The athletes lost 1.4 kg in body mass (P < 0.001), equal to 1.9% body mass. Fat mass remained stable and skeletal muscle mass decreased by 0.4 kg (P < 0.05). Prerace fat mass was correlated to total race time (r = 0.37, P < 0.05). The cyclists drank 6.5 (1.8) L of fluids during the race corresponding to 0.7 (0.2) L per hour. A significant inverse relationship was seen between change in body mass and race time when controlled for change in skeletal mass and fluid intake during the race (P > 0.05). Plasma sodium decreased by 0.7% (P < 0.05), plasma volume increased by 1.4%, and plasma urea increased by 40% (P < 0.05). Urinary-specific gravity increased by 0.4% (P < 0.05). The decrease in skeletal muscle mass was associated with the increase in plasma urea (r = -0.34; P < 0.05). Fluid intake was associated with the change in urinary-specific gravity (r = -0.45; P < 0.01). We conclude that these mountain bike ultra-marathoners suffered a significant decrease in body mass and skeletal muscle mass but no dehydration.

Background: Previous studies have extensively explored the correlation between preoperative skeletal muscle mass and long-term survival in gastrointestinal cancers. However, investigations into postoperative skeletal muscle mass alterations are limited. In gastrointestinal cancers, factors such as the tumor and surgical interventions can significantly impact dietary intake, nutritional status, and skeletal muscle mass, affecting postoperative body composition. This study aimed to examine these postoperative changes in skeletal muscle mass across different gastrointestinal cancers, including esophageal, gastric, and colorectum. Methods: This study encompassed 969 patients with Stage I-III esophageal (307 cases), gastric (278 cases), and colorectal (384 cases) cancers who underwent radical resection between 2005 and 2019. Skeletal muscle mass was quantified as the total psoas volume (TPV), measured using Ziostation2® imaging software from preoperative and postoperative CT scans at 1, 2, and 3 years. The study compared postoperative TPV trends across the different cancer types. Results: The study cohort comprised patients with esophageal (median age 66 years, 85% male), gastric (65 years, 60%), and colorectal cancers (67 years, 55%). Median BMIs were 21.5, 19.4, and 22.6 kg/m2, and median TPVs were 352.0, 305.8, and 309.5 cm3 for esophageal, gastric, and colorectal cancers, respectively. Esophageal cancer patients had significantly higher TPV and male predominance, while gastric cancer patients had notably lower BMI. Relative to preoperative TPV, the postoperative TPV at three years was 0.92, 0.91, and 0.96 for esophageal, gastric, and colorectal cancers, respectively. A year-by-year decrease in TPV was observed for each cancer type, with colorectal cancer demonstrating a less pronounced decrease compared to esophageal and gastric cancers (p&amp;lt;0.01). Stage-wise analysis revealed no significant differences among the cancer types. Regarding gender, no significant differences were noted between gastric and colorectal cancers, but esophageal cancer showed a more marked decrease in TPV in males compared to females. In recurrent cases, no significant TPV differences were observed in esophageal cancer, while recurrent gastric and colorectal cancers exhibited significant TPV decreases. Conclusions: The study indicates a general decline in TPV following gastrointestinal cancer surgery, with the extent of reduction varying according to the type of tumor and treatment. Citation Format: Yuto Maeda, Yuji Miyamoto, Mayuko Ohuchi, Yukiharu Hiyoshi, Naoya Yoshida, Hideo Baba. Changes in skeletal muscle mass after gastrointestinal cancer surgery by body composition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2401.