Chemotherapy-induced sarcopenia in newly diagnosed cancer patients: Izmir Oncology Group (IZOG) study

  • Utku OflazogluEmail author
  • Ahmet Alacacioglu
  • Umut Varol
  • Yuksel Kucukzeybek
  • Tarik Salman
  • Halil Taskaynatan
  • Yasar Yildiz
  • Seray Saray
  • M. Oktay Tarhan
Original Article



Sarcopenia is associated with physical disability, increased post-operative complications, poorer tolerance to chemotherapy, and reduced survival outcome. However, little is known about the changes in body composition during chemotherapy treatment. We aimed to determine whether adjuvant or palliative chemotherapy causes the development of sarcopenia in newly diagnosed cancer patients and to reveal the relationship of sarcopenia with the duration of chemotherapy.


The study included newly diagnosed cancer patients who underwent curative surgery for primary tumor and also cancer patients who were metastatic at diagnosis. Body composition and handgrip strength were assessed by bio-electric impedance analysis (BIA) and handgrip dynamometer tools, respectively. Measurement tests were performed prior to chemotherapy, in the third and sixth months of chemotherapy.


The median age of a total of 276 patients was 57.5 years (range 18–83), and majority of them (55.8%) were women. Among the pre-chemotherapy factors that could be associated with sarcopenia, male gender ≥ 65 years of age, body mass ındex (BMI) < 25, and nutritional risk screening 2002 score < 3 were found to be positively associated with sarcopenia (p < 0.001, p = 0.036, p < 0.001, and p < 0.001, respectively). In the multivariate analysis, male gender (p < 0.001) and BMI < 25 (p = 0.047) were found to be significant. Of 276 patients, 14.5% were sarcopenic prior to chemotherapy. After chemotherapy, 21.4% of them were sarcopenic at the end of the third month and 23.9% were sarcopenic at the end of the sixth month.


The incidence of sarcopenia was found to be increased with chemotherapy itself and its duration in both non-metastatic and metastatic cancer patients which has to be evaluated in detail in disease-specific prospective and randomized studies.


Sarcopenia Incidence Chemotherapy Body composition Bio-electric impedance analysis 



The authors gratefully acknowledge the support from friends Yasemin Payam, Betul Akdogan, Oksan Kacmaz, and Songul Uluc Ozaltaş.

Author contributions

Study concept: A Alacacioglu and U Oflazoglu. Study design: U Oflazoglu and A Alacacioglu. Data acquisition: U Oflazoglu, S Saray, Y Yildiz, and H Taskaynatan. Quality control of data: U Oflazoglu and A Alacacioglu. Data analysis and interpretation: U Oflazoglu and A Alacacioglu. Statistical analysis: U Oflazoglu and A Alacacioglu. Manuscript preparation: U Oflazoglu and U Varol. Manuscript editing: U Varol, A Alacacioglu, and T Salman. Manuscript review: U Varol, A Alacacioglu, Y Kucukzeybek, T Salman, and MO Tarhan

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board at Izmir Katip Celebi University.

Statement of informed consent

All patients provided written informed consent to participate in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical Oncology, Ataturk Training and Research HospitalIzmir Katip Celebi UniversityIzmirTurkey
  2. 2.Department of Medical Oncology, Institute of OncologyDokuz Eylul UniversityIzmirTurkey

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