Sarcopenia obesity associated with reduced overall survival and quality of life among cancer patients:JAMA

A recent study published in the Journal of American Medical Association on sarcopenic obesity (SO) revealed a significant correlation with reduced overall survival (OS), decreased quality of life (QoL) and increased likelihood of ICU admission.

Sarcopenic obesity (SO) is characterized by both obesity and reduced muscle mass and function. The prevalence of sarcopenia has now been observed even before old age among the individuals with chronic illnesses. Several studies have evaluated the muscle mass and strength to diagnose sarcopenia which revealed associations with diminished QoL and adverse outcomes in cancer patients. This study by Chenan Liu and team explored how common sarcopenic obesity (SO) is and its impact on outcomes in patients with solid tumor cancers by focusing specifically on its connections with overall survival and QoL among patients.

This prospective cohort study enrolled patients diagnosed with solid tumors from May 7, 2013 to June 30, 2022. The patients were classified into sarcopenic obesity and non-SO groups based on ESPEN-EASO criteria. The primary outcome examined was overall survival with secondary outcomes including patient quality of life and risk of intensive care unit admission. The data was analysis between June and December 2023.

The results showed that a total of 6790 patients participated in the study, with a mean (SD) age of 59.64 (10.77) years and 3489 were female (51.4%). The prevalence of SO was 4.36% (296 out of 6790) across the entire cohort and 14.98% (296 out of 1976) among those classified with obesity. SO prevalence rose with advancing age. Over a median (IQR) follow-up period of 6.83 (5.67-7.04) years, a total of 2103 patients passed away. Cox regression analysis revealed that SO independently correlated with decreased OS, observed consistently in both men and women. SO was also linked to diminished QoL and an increased risk of ICU admission. Among the diagnostic criteria for SO, low hand grip strength (HGS) was observed as the sole component associated with poorer OS.

Among the patients with solid tumors, sarcopenic obesity which was defined by ESPEN-EASO criteria, was present in 4.36% of the entire cohort and 14.98% of the individuals with obesity. Increased prevalence rates were observed among patients with breast, lung and colorectal cancers. SO expressed significant associations with quality of life, ICU admission rates and overall survival in cancer patients. Regular screening and diagnosis for SO are recommended for individuals with cancer and the ESPEN-EASO algorithm appears promising for clinical implementation in managing SO.

Reference:

Liu, C., Liu, T., Deng, L., Zhang, Q., Song, M., Shi, J., Liu, C., Xie, H., Chen, Y., Lin, S., Zheng, X., Zhang, H., Barazzoni, R., & Shi, H. (2024). Sarcopenic Obesity and Outcomes for Patients With Cancer. In JAMA Network Open (Vol. 7, Issue 6, p. e2417115). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.17115