Short CommunicationSARC-F has low correlation and reliability with skeletal muscle mass index in older gastrointestinal cancer patients
Introduction
Cancer results from an irregular increase in malignant cells and is one of the leading causes of morbidity and mortality [1,2]. Metabolic alterations and malnutrition are often associated with an exacerbated inflammatory response, decompensated proteolysis, negative nitrogenous balance and weight loss, particularly of the muscle mass [[3], [4], [5]]. This common condition among cancer patients is associated with worse prognosis. Additionality, the loss of muscle mass promotes imbalance and damage in functional capacity [6,7].
Thus, assessment of function and muscle mass is crucial to reduce comorbidities in cancer patients. Clinical routines use practical and fast screening tools to measure muscle mass. One of these tools is the Simple Questionnaire to Rapidly Diagnose Sarcopenia (SARC-F) that assesses muscle function [5,8,9]. Besides, evaluation of the skeletal muscle mass may be estimated using Lee's equation [10]. However, there are no studies that analyzed these two methods in the evaluation of loss muscle mass and function risk in gastrointestinal cancer patients. We hypothesized that SARC-F is useful to assessment the muscle function, but not muscle mass. Therefore, this study aimed to evaluate the correlation and reliability between SARC-F and the skeletal muscle mass index (SMI) in older gastrointestinal cancer patients.
Section snippets
Study design and patients
A cross-sectional study was conducted between December 2017 and October 2018 at the Public Hospital. We screened 114 older patients (63.55 ± 8.9 years) of both sexes with a diagnosis of gastrointestinal tract cancer who were currently undergoing anticancer therapy (chemotherapy, radiotherapy, or surgery). Of these, six patients were excluded from the study due to incomplete data, and 108 (80.5% male) patients were enrolled (Fig. 1). The patients were informed of the study and signed the written
Results
We found that 18.5% of patients presented normal muscle function. The most of patients was male (80.5%). We observed a high rate of thinness (BMI = 23.5 kg/m2) and low skeletal muscle mass (SMI = 81.5%). The primary diagnosis was colorectal cancer (48.1%) and 21.3% of the cases were liver metastasis. In addition, the most commonly treatment between these patients was neoadjuvant therapy (chemotherapy before surgery; 43.5%) and the least frequent was radiotherapy (0.9%) (Table 1).
Although, the
Discussion
In our study, 81.5% of patients presented low muscle function and mass. Although we observed that most of the values obtained from Lee's equation and the SARC-F were within the agreement limit, there was low correlation and reliability between them.
The muscle mass loss was identified by Lee's equation and can be found into acute (cachexia) or chronic (sarcopenia) forms [16]. Cancer patients may develop cachexia, which is sustained by an inflammatory state, insulin resistance and muscle loss due
Funding sources
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Statement of authorship
JDPS and GDP are responsible for conception of study. JDPS, JMS and ICLO performed data acquisition. JDPS, JMS, ICLO and GDP interpreted data, statistical analysis, contributed to manuscript revision and wrote the manuscript. All authors have read and approved the final version of the manuscript.
Conflict of interest
The authors declare no funding sources or conflicts of interest.
Acknowledgement
JMS and JDPS would like to thank the Capes, Brazil. GDP would like to thank The Brazilian National Council for Scientific and Technological Development (CNPq, Brazil, 312252/2019-6). We would like to thank the patients.
References (32)
- et al.
Definition and classification of cancer cachexia: an international consensus
Lancet Oncol
(2011) - et al.
SARC-F: a simple questionnaire to rapidly diagnose sarcopenia
J Am Med Dir Assoc
(2013) - et al.
Total-body skeletal muscle mass : development and cross-validation
Am J Clin Nutr
(2000) - et al.
Prevalence and associated factors of sarcopenia among elderly in Brazil: findings from the SABE study
J Nutr Health Aging
(2014) - et al.
Enhancing SARC-F: improving sarcopenia screening in the clinical practice
J Am Med Dir Assoc
(2016) - et al.
Prognostic value of sarcopenia in adults with solid tumours: a meta-analysis and systematic review
Eur J Cancer
(2016) - et al.
Sarcopenia screened by the SARC-F questionnaire and physical performances of elderly women: a cross-sectional study
J Am Med Dir Assoc
(2017) - et al.
Validating the SARC-F: a suitable community screening tool for sarcopenia?
J Am Med Dir Assoc
(2014) - et al.
ESPEN expert group recommendations for action against cancer-related malnutrition
Clin Nutr
(2017) - et al.
Global cancer statistics 2018 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
CA Cancer J Clin
(2018)
The global burden of cancer: priorities for prevention
Carcinogenesis
Sarcopenia is associated with quality of life and depression in patients with advanced cancer
Oncologist
Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane based chemotherapy
Clin Cancer Res
Muscle function loss is associated with anxiety in patients with gastrointestinal cancer
Clin Nutr ESPEN
Sarcopenia: revised European consensus on definition and diagnosis
Age Ageing
SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes
J Cachexia Sarcopenia Muscle
Cited by (12)
MSRA has low concordance with skeletal muscle mass index in mixed cancer patients: A preliminary and feasibility study
2022, Clinical Nutrition ESPENCitation Excerpt :Subsequently, Body Mass Index (BMI) was calculated (kg/m2). Appendicular muscle mass (ASM) was calculated using the LEE formula: ASM = 0.244 × Body weight + 7.80 × Height - 0.098 × Age + 6.6 × Sex + Race - 3.3 [6], for sex, 0 was used for women and 1 for men, and for race, 0 was used for whites, 1.4 for blacks, and 1.2 for Asians. Next, ASM was divided by height squared to obtain SMI values (skeletal muscle index).
High Charlson comorbidity index value is not associated with muscle strength in unselected cancer patients
2022, Clinical Nutrition ESPENCitation Excerpt :This condition is associated with the risk of morbidity and mortality among oncologic patients [6]. Likewise, Charlson Comorbidity Index (CCI) is an easy-to-use tool [7] commonly used to found that patients with risk for sarcopenia, when assessed by strength, assistance in walking, rise from a chair, climb stairs and falls (SARC-F), which is a good indicator of low strength and functional capacity [8,9], had more comorbidities, when evaluated by the ICC questionnaire [10]. In other study, Borges, Gomes, and Pimentel [11] found that 40% of cancer patients had risk of sarcopenia and its presence could predict the risk of comorbidities by 29%.
Systemic inflammation with sarcopenia predicts survival in patients with gastric cancer
2023, Journal of Cancer Research and Clinical Oncology