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Sarcopenia in Oncology or Gerontology: What Is the Difference?

  • Hematology and Oncology (GR Williams, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Low muscle mass, commonly known as sarcopenia, has been a focus of gerontologic research for many years and is related to reduced health-related quality of life, functional impairment, and shortened survival.

Recent Findings

In oncology, body composition research, including sarcopenia, has emerged as an area of particular interest in the last several years, as sarcopenia is highly prevalent in patients with cancer regardless of age and is correlated with adverse treatment outcomes and shorter survival.

Summary

In this review, we discuss the differences between sarcopenia in gerontology and oncology, including the differences in definition, diagnosis, pathophysiology, outcomes, and future directions.

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Abbreviations

CT:

Computed tomography

DEXA:

Dual-energy X-ray absorptiometry

MRI:

Magnetic resonance imaging

ICD:

International Classification of Diseases

EWGSOP:

European Working Group on Sarcopenia in Older People

SMI:

Skeletal muscle index

ASM:

Appendicular skeletal muscle mass

SMA:

Skeletal muscle area

TPA:

Total psoas area

BIA:

Bioimpedance analysis

SPPB:

Short Physical Performance Battery

UPS:

Ubiquitin-proteasome system

HCC:

Hepatocellular carcinoma

ECOG:

Eastern Cooperative Oncology Group

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010;39:412–23.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Rosenberg IH. Sarcopenia: origins and clinical relevance. Clin Geriatr Med. 2011; https://doi.org/10.1016/j.cger.2011.03.003.

  3. Fearon K, Evans WJ, Anker SD. Myopenia—a new universal term for muscle wasting. J Cachexia Sarcopenia Muscle. 2011;2:1–3.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998; https://doi.org/10.1186/1471-2318-7-5.

  5. Pinto Neto LF da S, Sales MC, Scaramussa ES, da Paz CJC, Morelato RL. Human immunodeficiency virus infection and its association with sarcopenia. Brazilian J Infect Dis. 2016;20:99–102.

  6. Rier HN, Jager A, Sleijfer S, Maier AB, Levin M-D. The prevalence and prognostic value of low muscle mass in cancer patients: a review of the literature. Oncologist. 2016:1–14.

  7. Baracos VE, Reiman T, Mourtzakis M, Gioulbasanis I, Antoun S. Body composition in patients with non-small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. Am J Clin Nutr. 2010; https://doi.org/10.3945/ajcn.2010.28608C.

  8. Martin L, Birdsell L, MacDonald N, Reiman T, Clandinin MT, McCargar LJ, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol. 2013; https://doi.org/10.1200/JCO.2012.45.2722.

  9. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003; https://doi.org/10.1152/japplphysiol.00246.2003.

  10. Kilgour RD, Vigano A, Trutschnigg B, Lucar E, Borod M, Morais JA. Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients. Support Care Cancer. 2013; https://doi.org/10.1007/s00520-013-1894-4.

  11. • Williams GR, Deal AM, Muss HB, Weinberg MS, Sanoff HK, Nyrop KA, et al. Skeletal muscle measures and physical function in older adults with cancer: sarcopenia or myopenia? Oncotarget. 2017; 10.18632/oncotarget.16866. This novel study emphasizes the differences of sarcopenia definitions between gerontology and oncology and shows that low muscle mass obtained from CT scans is not correlated with physical function impairment in older patients with cancer.

  12. Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84:475–82.

  13. Lecker SH, Jagoe RT, Gilbert A, Gomes M, Baracos V, Bailey J, et al. Multiple types of skeletal muscle atrophy involve a common program of changes in gene expression. FASEB J. 2004; https://doi.org/10.1096/fj.03-0610com.

  14. Jones A, Shen W, St-Onge M-P, Gallagher D, Heshka S, Wang Z, et al. Body-composition differences between African American and white women: relation to resting energy requirements. Am J Clin Nutr. 2004;79:780–78.

  15. Schakman O, Gilson H, Thissen JP. Mechanisms of glucocorticoid-induced myopathy. J Endocrinol. 2008; https://doi.org/10.1677/JOE-07-0606.

  16. Argilés JM, Busquets S, Stemmler B, López-Soriano FJ. Cachexia and sarcopenia: mechanisms and potential targets for intervention. Curr Opin Pharmacol. 2015;22:100–6.

    Article  PubMed  Google Scholar 

  17. Cawthon PM, Marshall LM, Michael Y, Dam TT, Ensrud KE, Barrett-Connor E, et al. Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc. 2007; https://doi.org/10.1111/j.1532-5415.2007.01259.x.

  18. Kazemi-Bajestani SMR, Mazurak VC, Baracos V. Computed tomography-defined muscle and fat wasting are associated with cancer clinical outcomes. Semin Cell Dev Biol. 2016; https://doi.org/10.1016/j.semcdb.2015.09.001.

  19. Tegels JJW, van Vugt JLA, Reisinger KW, Hulsewe KWE, Hoofwijk AGM, Derikx JPM, et al. Sarcopenia is highly prevalent in patients undergoing surgery for gastric cancer but not associated with worse outcomes. J Surg Oncol. 2015; https://doi.org/10.1002/jso.24015.

  20. Sharma P, Zargar-Shoshtari K, Caracciolo JT, Fishman M, Poch MA, Pow-Sang J, et al. Sarcopenia as a predictor of overall survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. Urol Oncol Semin Orig Investig. 2015; https://doi.org/10.1016/j.urolonc.2015.01.011.

  21. Mir O, Coriat R, Blanchet B, et al. Sarcopenia predicts early dose-limiting toxicities and pharmacokinetics of sorafenib in patients with hepatocellular carcinoma. PLoS One. 2012; https://doi.org/10.1371/journal.pone.0037563.

  22. Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008; https://doi.org/10.1016/S1470-2045(08)70153-0.

  23. Zhuang C-L, Huang D-D, Pang W-Y, Zhou C-J, Wang S-L, Lou N et al. Sarcopenia is an independent predictor of severe postoperative complications and long-term survival after radical gastrectomy for gastric cancer. Med (Baltimore) 2016;95:e3164.

  24. Jones K, Gordon-Weeks A, Coleman C, Silva M. Radiologically determined sarcopenia predicts morbidity and mortality following abdominal surgery: a systematic review and meta-Analysis. World J Surg. 2017; https://doi.org/10.1007/s00268-017-3999-2.

  25. Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. Br J Cancer. 2012;107:931–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Prado CMM, Lima ISF, Baracos VE, Bies RR, McCargar LJ, Reiman T, et al. An exploratory study of body composition as a determinant of epirubicin pharmacokinetics and toxicity. Cancer Chemother Pharmacol. 2011; https://doi.org/10.1007/s00280-010-1288-y.

  27. Prado CMM, Baracos VE, McCargar LJ, Reiman T, Mourtzakis M, Tonkin K, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009; https://doi.org/10.1158/1078-0432.CCR-08-2242.

  28. Shachar SS, Deal AM, Weinberg M, Williams GR, Nyrop KA, Popuri K, et al. Body composition as a predictor of toxicity in patients receiving anthracycline and taxane based chemotherapy for early stage breast cancer. Clin Cancer Res. 2017;23:3537–43.

  29. Antoun S, Baracos VE, Birdsell L, Escudier B, Sawyer MB. Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol. 2010;21:1594–8.

    Article  CAS  PubMed  Google Scholar 

  30. Yip C, Dinkel C, Mahajan A, Siddique M, Cook GJR, Goh V. Imaging body composition in cancer patients: visceral obesity, sarcopenia and sarcopenic obesity may impact on clinical outcome. Insights Imaging. 2015; https://doi.org/10.1007/s13244-015-0414-0.

  31. Huang D-D, Wang S-L, Zhuang C-L, Zheng B-S, Lu J-X, Chen F-F, et al. Sarcopenia, as defined by low muscle mass, strength and physical performance, predicts complications after surgery for colorectal cancer. Color Dis. 2015; https://doi.org/10.1111/codi.13067.

  32. Malietzis G, Johns N, Al-Hassi HO, Knight SC, Kennedy RH, Fearon KCH, et al. Low muscularity and myosteatosis is related to the host systemic inflammatory response in patients undergoing surgery for colorectal cancer. Ann Surg. 2015; https://doi.org/10.1097/SLA.0000000000001113.

  33. • Shachar SS, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours: a meta-analysis and systematic review. Eur J Cancer. 2016;57:58–67. This meta-analysis showed the important prognostic value of sarcopenia in patients with cancer, demonstrating a significantly poorer survival in patients with cancer who had low muscle mass. (These results were seen across different tumor types and disease stages.)

    Article  PubMed  Google Scholar 

  34. Carneiro IP, Mazurak VC, Prado CM. Clinical implications of sarcopenic obesity in cancer. Curr Oncol Rep. 2016; https://doi.org/10.1007/s11912-016-0546-5.

  35. Han K, Park Y-M, Kwon H-S, Ko S-H, Lee S-H, Yim HW, et al. Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008–2010. PLoS One. 2014;9:e86902.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Chin SO, Rhee SY, Chon S, et al. Sarcopenia is independently associated with cardiovascular disease in older Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES) from 2009. PLoS One. 2013;8:e60119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Jackson SE, Chester JD. Personalised cancer medicine. Int J Cancer. 2015; https://doi.org/10.1002/ijc.28940.

  38. Courneya KS, Segal RJ, Mackey JR, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404.

    Article  PubMed  Google Scholar 

  39. Adams SC, Segal RJ, McKenzie DC, Vallerand JR, Morielli AR, Mackey JR, et al. Impact of resistance and aerobic exercise on sarcopenia and dynapenia in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. Breast Cancer Res Treat. 2016;158:497–507.

    Article  CAS  PubMed  Google Scholar 

  40. Gioulbasanis I, Baracos VE, Giannousi Z, Xyrafas A, Martin L, Georgoulias V, et al. Baseline nutritional evaluation in metastatic lung cancer patients: mini nutritional assessment versus weight loss history. Ann Oncol. 2011; https://doi.org/10.1093/annonc/mdq440.

  41. Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016;7:512–4.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011; https://doi.org/10.1016/S1470-2045(10)70218-7.

  43. Clark BC, Manini TM. What is dynapenia? Nutrition. 2012;28:495–503.

    Article  PubMed  PubMed Central  Google Scholar 

  44. •• Reijnierse EM, Trappenburg MC, Leter MJ, et al. The impact of different diagnostic criteria on the prevalence of sarcopenia in healthy elderly participants and geriatric outpatients. Gerontology. 2015;61:491–6. In 2016, Sarcopenia was recognized as an entity of its own in the ICD10, marking its growing importance and increased interest in the research and clinical field.

    Article  PubMed  Google Scholar 

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Correspondence to Shlomit Strulov Shachar.

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Shlomit Strulov Shachar and Noa Shafran declare no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hematology and Oncology

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Shachar, S.S., Shafran, N. Sarcopenia in Oncology or Gerontology: What Is the Difference?. Curr Geri Rep 6, 213–218 (2017). https://doi.org/10.1007/s13670-017-0220-2

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  • DOI: https://doi.org/10.1007/s13670-017-0220-2

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