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Skeletal muscle mass as a marker to predict outcomes in children and young adults with cancer

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Abstract

Purpose

Nutrition is an important outcome predictor in oncology patients including treatment response, physical disability, quality of life, and overall survival. Sarcopenia (loss of skeletal muscle mass and function) is a demonstrated marker of nutritional status in adults, but data are more limited in children. The purpose of this study was to evaluate whether total psoas muscle area (tPMA) measured at the time of cancer diagnosis predicts overall survival (OS), disease free survival (DFS), or number of days neutropenic.

Methods

A retrospective study was performed. tPMA was measured at the L3 and L4 mid-lumbar vertebral body level by a single reviewer on cross-sectional imaging studies performed within 2 weeks of primary oncologic diagnosis for all oncology patients who received their primary therapy at Cincinnati Children’s Hospital between 1/1/2000 and 12/31/2013. Spearman’s correlation was used to assess the association between tPMA and OS, DFS, days neutropenic, and adjusted days neutropenic. Subanalysis was performed assessing the relationship of tumor type and age at diagnosis with each parameter.

Results

164 patients (median age 9.9 years; 89 M/75 F) were included in the study. Days neutropenic and normalized days neutropenic were significantly but weakly negatively correlated with tPMA at L3 (r =  − 0.24, p < 0.002 and r =  − 0.18, p < 0.05 respectively) and L4 (r =  − 0.25, p < 0.002; and and r =  − 0.19, p < 0.02 respectively). At subanalysis, the correlation between anthropometric features and normalized days neutropenic was only seen with brain tumors. There was no statistically significant relationship between sarcopenia at diagnosis and DFS or OS overall or in subanalysis.

Conclusion

There is a weak inverse relationship between days neutropenic and psoas muscle bulk in pediatric and young adult oncology patients suggesting a relationship between nutritional status and cell recovery. Measures of sarcopenia, however, did not correlate with DFS or OS.

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Data availability

The data that support the findings of this study are available from the corresponding author, AJT, upon reasonable request.

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Funding

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Author information

Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC, 29245, USA

    Morgan P. McBee

  2. Department of Pediatrics, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC, 29245, USA

    Morgan P. McBee

  3. Department of Neurosurgery, 320 E North Ave, Pittsburgh, PA, 15212, USA

    Cody Woodhouse

  4. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Andrew T. Trout, Ethan A. Smith & Alexander J. Towbin

  5. Department of Radiology, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA

    Andrew T. Trout, Ethan A. Smith & Alexander J. Towbin

  6. Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA

    Andrew T. Trout, Ethan A. Smith, Bin Zhang & Alexander J. Towbin

  7. Division of Oncology, Cincinnati Children’s Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    James I. Geller

  8. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Bin Zhang

Authors
  1. Morgan P. McBee
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  2. Cody Woodhouse
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  7. Alexander J. Towbin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MM and BZ. The first draft of the manuscript was written by MM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alexander J. Towbin.

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Conflict of interest

Andrew T. Trout Grant funding: Siemens Medical Solutions; Canon Medical Systems, Research support: Perspectum, Honoraria for authorship: Elsevier; Wolters-Kluwer. Alexander J. Towbin—Grant funding: Guerbet; Cystic Fibrosis Foundation, Unpaid advisory board member: IBM Watson Health, KLAS, Consultant: Applied Radiology, Author royalties: Elsevier. Morgan P. McBee and Cody Woodhouse, James I. Geller, Ethan A. Smith and Bin Zhang declares that they have no conflict of interest.

Ethical approval

This retrospective HIPAA compliant study was approved by the institutional review board.

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McBee, M.P., Woodhouse, C., Trout, A.T. et al. Skeletal muscle mass as a marker to predict outcomes in children and young adults with cancer. Abdom Radiol 47, 452–459 (2022). https://doi.org/10.1007/s00261-021-03301-7

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  • DOI: https://doi.org/10.1007/s00261-021-03301-7

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