ASSOCIATION BETWEEN CHARACTERISTICS OF SKELETAL MUSCLE MASS AND MORTALITY IN ELDERLY PEOPLE WITH GASTROINTESTINAL CANCER: LONGITUDINAL STUDY
Gastrointestinal cancer, handgrip, dynapenia, mortality.
In the oncological literature the low muscular quantity, myosteatosis, and the muscular and physical function, are considered excellent biomarkers of poor prognosis. Despite the growing evidence, to date, there are no studies that have jointly examined the predictive potential of markers of muscular quantity, myosteatosis, and muscle and physical function for cancer mortality. The aim of the present study was to examine the predictive potential of markers of muscle quantity, myosteatosis, and muscle and physical function for mortality in elderly patients with gastrointestinal cancer. One hundred and eighty-nine elderly patients (mean age 69.2 ± 7.9 years; 56.6%, male; 44.4% female) with gastrointestinal cancer were included in this longitudinal study. Computed tomography images of the abdominal region assessed skeletal muscle mass using Slice-O-Matic software version 5.0 (Tomovision,
Montreal, Canada) to determine the parameters of skeletal muscle index (muscle quantity) and muscle radiodensity (myosteatosis). Muscle function was assessed using the handgrip strength test and physical function by gait speed. At the end of the 36-month follow-up, 53 deaths (28%) were recorded. A little more than half of the sample was classified as dynapenic (50.3%), resulting in the analysis of Cox's proportional risk, the handgrip strength was the only significant predictor of death after adjusting for the confounding variables (age, sex, BMI, type of treatment and tumor staging) (1.93; 95% CI [1.62-2.97], p <0.04). We conclude that the presence of dynapenia seems to be associated with a higher risk of death in the elderly with gastrointestinal cancer, and it is advisable that the assessment of handgrip strength be included in practice. In addition, it is suggested that elderly patients with gastrointestinal cancer identified with dynapenia be advised to start a resistance exercise program, combined with other measures of healthy lifestyle aiming at a better prognosis.