Association of possible sarcopenia with all-cause mortality in patients with solid cancer: A nationwide multicenter cohort study

• Main Authors: Liangyu Yin (Author), Chunhua Song (Author), Jiuwei Cui (Author), Xin Lin (Author), Na Li (Author), Yang Fan (Author), Ling Zhang (Author), Jie Liu (Author), Feifei Chong (Author), Minghua Cong (Author), Zengning Li (Author), Suyi Li (Author), Zengqing Guo (Author), Wei Li (Author), Hanping Shi (Author), Hongxia Xu (Author)
• Format: Book
• Published: Elsevier, 2024-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1760-4788; 10.1016/j.jnha.2023.100023
• Keywords: Calf circumference; Handgrip strength; Sarcopenia; Cancer; Mortality; Internal medicine; RC31-1245
• Source: The Journal of Nutrition, Health and Aging, Vol 28, Iss 1, Pp 100023- (2024)

Objectives: The concept of possible sarcopenia (PS) was recently introduced to enable timely intervention in settings without the technologies required to make a full diagnosis of sarcopenia. This study aimed to investigate the association between PS and all-cause mortality in patients with solid cancer. Design: Retrospective observational study. Setting and participants: 13,736 patients with 16 types of solid cancer who were ≥18 years old. Measurements: The presence of both a low calf circumference (men <34 cm or women <33 cm) and low handgrip strength (men <28 kg or women <18 kg) was considered to indicate PS. Harrell's C-index was used to assess prognostic value and the association of PS with mortality was estimated by calculating multivariable-adjusted hazard ratios (HRs). Results: The study enrolled 7207 men and 6529 women (median age = 57.8 years). During a median follow-up of 43 months, 3150 deaths occurred. PS showed higher Harrell's C-index (0.549, 95%CI = [0.541, 0.557]) than the low calf circumference (0.541, 95%CI = [0.531, 0.551], P = 0.037) or low handgrip strength (0.542, 95%CI = [0.532, 0.552], P = 0.026). PS was associated with increased mortality risk in both univariate (HR = 1.587, 95%CI = [1.476, 1.708]) and multivariable-adjusted models (HR = 1.190, 95%CI = [1.094, 1.293]). Sensitivity analyses showed that the association of PS with mortality was robust in different covariate subgroups, which also held after excluding those patients who died within the first 3 months (HR = 1.162, 95%CI = [1.060, 1.273]), 6 months (HR = 1.150, 95%CI = [1.039, 1.274]) and 12 months (HR = 1.139, 95%CI = [1.002, 1.296]) after enrollment. Conclusion: PS could independently and robustly predict all-cause mortality in patients with solid cancer. These findings imply the importance of including PS assessment in routine cancer care to provide significant prognostic information to help mitigate sarcopenia-related premature deaths.