Department of Radiology, Marmara University School of Medicine, Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad., No: 10 Üst Kaynarca, Pendik, Istanbul, Turkey.
Department of Pediatric Hematology and Oncology, Marmara University, School of Medicine, Istanbul, Turkey.
Pediatr Radiol. 2023 May;53(5):854-861. doi: 10.1007/s00247-022-05583-5. Epub 2023 Jan 5.
Sarcopenia is an indicator of negative outcomes in many diseases in adults. Reports indicate this might also be true in children.
To evaluate the effect of sarcopenia and sarcopenic obesity on event-free survival (EFS) and overall survival (OS) in children with Ewing sarcoma and osteosarcoma.
We retrospectively measured total muscle areas of the pectoralis, paraspinal (T12 level) and psoas (L4 level) muscles and total abdominal muscle area (L3 level) on computed tomography images in 60 children diagnosed with either Ewing sarcoma (n = 34) or osteosarcoma (n = 26). Skeletal muscle indices (SMI) were calculated by normalizing muscle area to patient height. Vertebral morphologic parameters of T12 and L4 vertebrae were measured and correlated to patient height to use as a substitute in cases of missing height data (SMI and SMI). We calculated sarcopenic obesity index by dividing SMI by body mass index. We subdivided children into two groups according to the median value of each parameter and assessed the differences in survival between the groups.
No skeletal muscle index or sarcopenic obesity index parameter significantly affected event-free or overall survival in the total group analysis. In the non-metastatic group, higher values of SMI-paraspinal and SMI-psoas were correlated with longer event-free survival and no patient died in this group. Boys and children in the metastatic group with higher SMI-paraspinal values had significantly longer event-free survival and both event-free and overall survival, respectively.
Although some parameters were correlated with event-free and overall survival, neither sarcopenia nor sarcopenic obesity were reliably associated with survival in children with Ewing sarcoma or osteosarcoma.
在许多成人疾病中，肌肉减少症是负面预后的一个指标。有报告称，这在儿童中也可能是正确的。
评估在患有尤因肉瘤和骨肉瘤的儿童中，肌肉减少症和肌少性肥胖对无事件生存（EFS）和总生存（OS）的影响。
我们回顾性地测量了 60 名被诊断患有尤因肉瘤（n=34）或骨肉瘤（n=26）的儿童的计算机断层扫描图像上的胸肌、椎旁肌（T12 水平）和腰大肌（L4 水平）的总肌肉面积和总腹部肌肉面积（L3 水平）。通过将肌肉面积归一化为患者身高来计算骨骼肌指数（SMI）。测量 T12 和 L4 椎体的椎体形态学参数，并将其与患者身高相关联，以替代缺失身高数据的情况（SMI 和 SMI）。我们通过将 SMI 除以体重指数来计算肌少性肥胖指数。我们根据每个参数的中位数将儿童分为两组，并评估两组之间的生存差异。
在总组分析中，没有任何骨骼肌指数或肌少性肥胖指数参数显著影响无事件生存或总生存。在非转移性组中，较高的椎旁肌 SMI 和腰大肌 SMI 值与较长的无事件生存相关，且该组无患者死亡。在转移性组中，男孩和女孩的椎旁肌 SMI 值较高，无事件生存和总生存分别显著延长。
尽管一些参数与无事件生存和总生存相关，但在患有尤因肉瘤或骨肉瘤的儿童中，肌肉减少症或肌少性肥胖症均与生存无可靠关联。
