Abstract
Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson's correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.
Highlights
The computed tomography (CT) image was inaccessible for analysis in 79 patients (CT exams were older than 30 days)
The most frequent type was of colorectal cancer, followed by gastric tumor (27.8% and 22.2%, respectively), and advanced stages (III and IV) were diagnosed in more than a half of the patients (54.6%)
According to Body Mass Index (BMI) categories, 47.2% of patients classified with normal BMI and 30.6% with overweight
Summary
According to the World Health Organization (WHO), today, the number of people aged 60 years and older will outnumber children younger than 5 years [1]. In Brazil, “older adults” are 60 years of age or older, and it is estimated that this group will represent 18.6% in 2030 and 33.7% in 2060 of the total population [2]. The risk of cancer increases exponentially with age; about 60% of cancers occur in people of 65 years of age or older, and 70% of the deaths caused by cancers occur in this stage [3, 4]. The prevalence of malnutrition in patients with cancer varies according to the type and stage of the tumor, treatment performed, as well as age [5,6,7].
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