Abstract
Background: We evaluated nutritional and sarcopenia status and their clinical impact in pediatric patients affected by bone and soft tissue sarcomas. Methods: Body mass index (BMI), prognostic nutritional index (PNI), and total psoas muscle area (tPMA) at diagnosis and after 12 months were analyzed. tPMA was measured from single cross-sectional computed tomography (CT) images at L4–L5. Age-specific and sex-specific tPMA Z-scores were retrieved from an online calculator. Results: A total of 21 patients were identified between February 2013 and December 2018. Twelve patients (57.1%) experienced sarcopenia at diagnosis, although not statistically associated with overall survival (OS) (p = 0.09). BMI Z-score, PNI, and tPMA Z-score significantly decreased between diagnosis and after 12 months of treatment (p < 0.05). Univariate analysis showed significant associations between poor OS and the presence of metastasis (p = 0.008), the absence of surgery (p = 0.005), PNI decrease (p = 0.027), and the reduction in tPMA > 25% (p = 0.042) over the 12 months. Conclusions: Sarcopenia affects more than half of the patients at diagnosis. Decreased PNI during 12 months of treatment has significant predictive value for OS. The role of tPMA derived from CT scan among pediatric patients with sarcoma should be investigated in further prospective and larger studies.
Highlights
Nutritional status plays a key role in the growth, response to treatment, related complications, quality of life, cost of care, and hospital stay of pediatric patients admitted for various types of illness [1]
We evaluate body composition changes, sarcopenia assessed by the evaluation of PMA obtained from computed tomography (CT) scans, and their impact on the survival and prognosis of pediatric patients with bone and soft tissue sarcomas
A total of 22 patients diagnosed with a bone or soft tissue sarcoma and treated at our center were included between February 2013 and December 2018
Summary
Nutritional status plays a key role in the growth, response to treatment, related complications, quality of life, cost of care, and hospital stay of pediatric patients admitted for various types of illness [1]. In children hospitalized for cancer, malnutrition constitutes a very common complication, and it is influenced by the type and extent of disease, the intensity of treatment, and the patient’s living conditions [8]. In these patients, the inflammatory response of the underlying disease induces high-energy expenditure and protein catabolism with a net lean body mass loss. Age-specific and sex-specific tPMA Z-scores were retrieved from an online calculator
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