Sarcopenia: Clinical implications in ovarian cancer, diagnosis, etiology, and management

Abstract

Sarcopenia, loss of skeletal muscle and function, is a common condition among the elderly and is known to cause adverse health outcomes and increased risk of morbidity and mortality. This progressive and generalized disorder imposes a considerable socioeconomic burden. Sarcopenia is observed commonly in cancer patients. As Asia is one of the fastest aging regions in the world, it is clear that incidences of both sarcopenia and ovarian cancer will increase together in Asian countries. Ovarian cancer patients are vulnerable to develop sarcopenia during the treatment course and progress of disease, and a considerable number of patients with ovarian cancer seems to have physical inactivity and sarcopenia already at the time of diagnosis. Therefore, management of sarcopenia should be conducted together in parallel with ovarian cancer treatment and surveillance. Thus, in this article, we will review the clinical importance of sarcopenia in the aspect of ovarian cancer. Definition of sarcopenia, diagnosis, etiology, and intervention will be also introduced.

Keywords: ACEi, angiotensin converting enzyme inhibitor; ASM, appendicular skeletal muscle mass; AWGS, Asian Working Group for Sarcopenia; BIA, bioelectrical impedance analysis; BMI, body mass index; CINV, chemotherapy-induced nausea and vomiting; CT, computed tomography; DXA, dual-energy x-ray absorptiometry; Definition; EMT, epithelial-to-mesenchymal transition; EWGSOP, European Working Group on Sarcopenia in Older People; GH, growth hormone; HMB, β-hydroxy-β-methylbutyrate; HRT, hormone replacement therapy; IGF-1, insulin like growth factor-1; Intervention; L3, the third lumbar vertebra; MRI, magnetic resonance imaging; NLR, neutrophil to lymphocyte ratio; OECD, Organisation for Economic Co-operation and Development; OS, overall survival the length of time from either the date of diagnosis or the start of treatment for a cancer that patients diagnosed with the disease are still alive; Ovarian carcinoma; PFS, progression-free survival the length of time during and after the treatment of cancer that a patient lives with the disease but it does not get worse; Physiology; Practice; RM, repetition maximum; SARM, selective androgen receptor modulator; SMM, skeletal muscle mass; SPPB, Short Physical Performance Battery; Sarcopenia; TUG, Timed-Up and Go.