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术前评估结直肠癌患者的肌肉减少症:一项前瞻性研究。

Preoperative evaluation of sarcopenia in patients with colorectal cancer: a prospective study.

机构信息

A.C. Camargo Cancer Center - São Paulo (SP), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2023 Feb 10;69(2):222-227. doi: 10.1590/1806-9282.20220339. eCollection 2023.

Abstract

OBJECTIVE

Colorectal cancer is the third most diagnosed malignant neoplasm in the world and the fourth leading cause of cancer mortality. The loss of muscle mass in oncological patients is the main aspect of cancer-related malnutrition. Associations between sarcopenia and poor outcomes, such as high postoperative mortality, chemotherapy toxicity, and reduced survival, have been recently described. The aim of this study was to prospectively assess the prevalence of preoperative sarcopenia in patients with colorectal cancer using validated methods to evaluate muscle strength, muscle mass, and physical performance.

METHODOLOGY

This study included patients with colorectal cancer undergoing oncological staging at a Cancer Center in Brazil from May 2019 to March 2020 who had images from abdominal computed tomography available for analysis of body composition. The muscle strength test, physical performance, referred fatigue, and clinical and nutritional data were evaluated.

RESULTS

A total of 31 patients were included, and most were diagnosed with colon cancer (77.4%) and clinical stage II in 41.9% of cases. The prevalence of probable sarcopenia was 22.6%; of these patients, sarcopenia was confirmed in 19.4%, and ultimately, 9.7% of the sample was classified as severe sarcopenia. We did not find a significant association between the presence of sarcopenia in our sample and age, sex, tumor staging, nutritional characteristics, referred patient fatigue, or postoperative complications.

CONCLUSION

Considering the criteria established by the EWGSOP, the prevalence of preoperative sarcopenia in colorectal cancer patients was 19.4%.

摘要

目的

结直肠癌是世界上第三大被诊断出的恶性肿瘤,也是癌症死亡的第四大主要原因。肿瘤患者的肌肉质量损失是癌症相关营养不良的主要方面。最近描述了肌肉减少症与不良预后之间的关联,例如高术后死亡率、化疗毒性和降低的生存率。本研究的目的是使用评估肌肉力量、肌肉质量和身体表现的经过验证的方法,前瞻性评估结直肠癌患者术前肌肉减少症的患病率。

方法

本研究纳入了 2019 年 5 月至 2020 年 3 月在巴西癌症中心接受肿瘤分期的结直肠癌患者,这些患者有腹部计算机断层扫描的图像可供身体成分分析。评估了肌肉力量测试、身体表现、患者报告的疲劳、临床和营养数据。

结果

共纳入 31 例患者,大多数患者被诊断为结肠癌(77.4%),41.9%的病例为临床分期 II 期。可能存在肌肉减少症的患病率为 22.6%;在这些患者中,肌肉减少症得到了确认的占 19.4%,最终,样本中 9.7%的患者被归类为严重肌肉减少症。我们没有发现我们样本中存在肌肉减少症与年龄、性别、肿瘤分期、营养特征、患者报告的疲劳或术后并发症之间存在显著关联。

结论

根据 EWGSOP 制定的标准,结直肠癌患者术前肌肉减少症的患病率为 19.4%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/525a/9983475/e9515019ad07/1806-9282-1806-9282-20220339-gf01.jpg

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