The prevalence of CT-defined low skeletal muscle mass in patients with metastatic cancer: a cross-sectional multicenter French study (the SCAN study) - Supportive Care in Cancer
Source : https://link.springer.com/article/10.1007/s00520-021-06603-0
Background Cachexia, characterized by involuntary muscle mass loss, negatively impacts survival outcomes, treatment tolerability, and functionality in cancer patients. However, there is a limited appreciation of the true prevalence of low muscle mass due to inconsistent diagnostic methods and limited oncologist awareness.
Conclusions:There is a critical need to raise awareness of low skeletal muscle mass diagnosis among oncologists, and for improvements in nutritional management and physical therapies of cancer patients to curb potential cachexia. This calls for cross-disciplinary collaborations among oncologists, nutritionists, physiotherapists, and radiologists.
• Source: Supportive Care in Cancer
• Conclusion/Relevance: “There is a critical need to raise awareness of low skeletal muscle mass diagnosis among oncologists, and for improvements in nutritional management and physical therapies of cancer patients to curb potential cachexia. This calls for cross-disciplinary collaborations among oncologists, nutritionists, physiotherapists, and radiologists.”
• In the current cross-sectional study, French researchers enrolled 766 patients with metastatic cancer from the colon, breast, prostate, lung, and kidney. The primary endpoint was low-skeletal muscle mass as measured by the skeletal mass index at the level of L3 per CT.
• Sarcopenia occurred in 69.1% of patients, and the results of the current study support the use of CT to measure muscle loss to improve diagnosis and treatment.
• Low muscle mass occurred in more men than women. Sarcopenia was most prevalent in prostate cancer (94.4%) and least common in breast cancer (54.3%). Those with prostate cancer typically have many risk factors including older age, testosterone deprivation, and advanced cancer.
• “The most worrying result of our study is that despite its high prevalence, practitioners were unable to recognize low skeletal muscle mass in nearly half of those patients with low muscle mass during the survey, even while completing nutritional status data. Low muscle mass was more poorly recognized in obese patients,” wrote the authors. “Our findings also demonstrate the general lack of nutritional and physical therapy support available to cancer patients in France, as not more than a third of patients with low muscle mass were receiving nutritional counselling or nutritional management (in the form of supplements, enteral or parenteral nutrition).
• Limitations of the current study include the evaluation of low muscle mass via historical data taken from the medical record. Furthermore, the cross-sectional design precluded elucidation of the progression of cancer-related sarcopenia over time. Another limitation was the use of Canadian cut-offs to evaluate sarcopenia in a French population, with body weight varying between the two populations.