Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

PLoS One. 2021 Sep 14;16(9):e0257446. doi: 10.1371/journal.pone.0257446. eCollection 2021.

Abstract

Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson's correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Anthropometry
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Female
  • Hand Strength
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Medical Oncology / standards*
  • Middle Aged
  • Muscle, Skeletal / physiopathology
  • Neoplasms / complications*
  • Neoplasms / diagnosis*
  • Neoplasms / epidemiology
  • Neoplasms / mortality
  • Predictive Value of Tests
  • Prevalence
  • Sarcopenia / complications*
  • Sarcopenia / diagnosis*
  • Sarcopenia / epidemiology
  • Sarcopenia / mortality
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Grants and funding

The authors declare that this study received partial financial support from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. Furthermore, there was no additional external funding received for this study.