Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande Do Norte, Senador Salgado Filho Avenue, nº 3000, Natal, RN, 59078-970, Brazil.
Support Care Cancer. 2023 Jun 2;31(6):370. doi: 10.1007/s00520-023-07845-w.
Sarcopenia is a muscle dysfunction that increases negative outcomes in patients with cancer. However, its diagnosis remains uncommon in clinical practice. The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is a questionnaire to assess the functional status, but it is unknown if is comparable with sarcopenia. We aimed at comparing ECOG-PS with sarcopenia to predict 12-month mortality in patients with cancer.
Cohort study including older adult patients with cancer in treatment (any stage of the disease or treatment) at a reference hospital for oncological care. Socio-demographic, clinical, and anthropometric data, muscle mass, and physical function variables (handgrip strength [HGS] and gait speed [GS]) were collected. Skeletal muscle quantity and quality were assessed by computed tomography at the L3. Sarcopenia was diagnosed according to the EWGSP2. ECOG-PS and all-cause mortality were evaluated. The Cox proportional hazards model was calculated.
We evaluated 159 patients (69 years old, 55% males). Low performance (ECOG-PS ≥ 2) was found in 23.3%, 35.8% presented sarcopenia, and 22.0% severe sarcopenia. ECOG-PS ≥ 2 was not an independent predictor of mortality. Sarcopenia, severe sarcopenia, and probable sarcopenia has increased by 3.25 (confidence interval, CI 95% 1.55-6.80), 2.64 (CI 95% 1.23-5.67), and 2.81 (CI 95% 1.30-6.07) times the risk of mortality, respectively.
Sarcopenia, but not ECOG-PS, was a predictor of mortality. Therefore, ECOG-PS was not similar to sarcopenia to predict mortality in patients with cancer.
肌肉减少症是一种肌肉功能障碍,会增加癌症患者的不良预后。然而,在临床实践中,其诊断仍然不常见。东部合作肿瘤组体能状态(ECOG-PS)是一种评估功能状态的问卷,但尚不清楚其是否与肌肉减少症相当。我们旨在比较 ECOG-PS 与肌肉减少症,以预测癌症患者 12 个月的死亡率。
这是一项队列研究,纳入了在一家肿瘤治疗参考医院接受治疗的老年癌症患者(任何疾病阶段或治疗阶段)。收集了社会人口统计学、临床和人体测量学数据、肌肉质量以及身体功能变量(握力[HGS]和步态速度[GS])。通过腰椎 L3 的计算机断层扫描评估骨骼肌数量和质量。根据 EWGSP2 诊断肌肉减少症。评估 ECOG-PS 和全因死亡率。计算 Cox 比例风险模型。
我们评估了 159 名患者(69 岁,55%为男性)。23.3%的患者体能状态较差(ECOG-PS≥2),35.8%的患者存在肌肉减少症,22.0%的患者存在严重肌肉减少症。ECOG-PS≥2 不是死亡的独立预测因素。肌肉减少症、严重肌肉减少症和可能的肌肉减少症使死亡率的风险分别增加了 3.25(95%可信区间,CI 95%为 1.55-6.80)、2.64(CI 95%为 1.23-5.67)和 2.81(CI 95%为 1.30-6.07)倍。
肌肉减少症而非 ECOG-PS 是死亡率的预测因素。因此,ECOG-PS 与肌肉减少症不同,不能用于预测癌症患者的死亡率。