1. Different Impact of Definitions of Sarcopenia in Defining Frailty Status in a Population of Older Women with Early Breast Cancer
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Luca Tagliaferri, Beatrice Di Capua, Andrea Bellieni, Domenico Fusco, Riccardo Masetti, Roberto Bernabei, Giuseppe Colloca, Alejandro Martin Sanchez, Enrico Di Stasio, Gianluca Franceschini, Fabio Marazzi, and Elena Allocca
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Gerontology ,Settore MED/18 - CHIRURGIA GENERALE ,Population ,lcsh:Medicine ,Medicine (miscellaneous) ,frailty ,Muscle mass ,Article ,sarcopenia ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,030212 general & internal medicine ,education ,Early breast cancer ,education.field_of_study ,business.industry ,lcsh:R ,Significant difference ,Cancer ,Common Terminology Criteria for Adverse Events ,physical performance ,musculoskeletal system ,Tailored treatment ,medicine.disease ,030220 oncology & carcinogenesis ,Sarcopenia ,older cancer patients ,business ,human activities - Abstract
Sarcopenia is a geriatric syndrome characterized by losses of quantity and quality of skeletal muscle, which is associated with negative outcomes in older adults and in cancer patients. Different definitions of sarcopenia have been used, with quantitative data more frequently used in oncology, while functional measures have been advocated in the geriatric literature. Little is known about the correlation between frailty status as assessed by comprehensive geriatric assessment (CGA) and sarcopenia in cancer patients. We retrospectively analyzed data from 96 older women with early breast cancer who underwent CGAs and Dual X-ray Absorptiometry (DXA) scans for muscle mass assessment before cancer treatment at a single cancer center from 2016 to 2019 to explore the correlation between frailty status as assessed by CGA and sarcopenia using different definitions. Based on the results of the CGA, 35 patients (36.5%) were defined as frail. Using DXA Appendicular Skeletal Mass (ASM) or the Skeletal Muscle Index (SMI=ASM/height^2), 41 patients were found to be sarcopenic (42.7%), with no significant difference in prevalence between frail and nonfrail subjects. Using the European Working Group on Sarcopenia in Older People (EWGSOP2) definition of sarcopenia (where both muscle function and mass are required), 58 patients were classified as “probably” sarcopenic, among these, 25 were sarcopenic and 17 “severely” sarcopenic. Only 13 patients satisfied both the requirements for being defined as sarcopenic and frail. Grade 3-4 treatment-related toxicities (according to Common Terminology Criteria for Adverse Events) were more common in sarcopenic and frail sarcopenic patients. Our data support the use of a definition of sarcopenia that includes both quantitative and functional data in order to identify frail patients who need tailored treatment.
- Published
- 2021
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