Oncotarget

Research Papers:

Muscle mass, not radiodensity, predicts physical function in cancer patients with or without cachexia

Lindsey J. Anderson, Nicole Chong, Dorota Migula, Adam Sauer, Michelle Garrison, Peter Wu, Atreya Dash and Jose M. Garcia _

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Oncotarget. 2020; 11:1911-1921. https://doi.org/10.18632/oncotarget.27594

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Abstract

Lindsey J. Anderson1, Nicole Chong1, Dorota Migula1, Adam Sauer1, Michelle Garrison3, Peter Wu2,4, Atreya Dash5,6 and Jose M. Garcia1,7

1 Geriatric Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA

2 Department of Surgery, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA

3 Department of Health Services, University of Washington, Seattle, Washington, USA

4 Department of Surgery, University of Washington, Seattle, Washington, USA

5 Department of Urology, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA

6 Department of Urology, University of Washington, Seattle, Washington, USA

7 Gerontology and Geriatric Medicine-Department of Medicine, University of Washington, Seattle, Washington, USA

Correspondence to:

Jose M. Garcia,email: jose.garcia@va.gov

Keywords: cancer cachexia; physical function; computed tomography; muscle radiodensity

Received: February 24, 2020     Accepted: April 27, 2020     Published: May 19, 2020

ABSTRACT

Background: There is a need to better understand the relationship between functional impairment and muscle mass in cancer cachexia. This study aimed to establish the relationship between computed tomography (CT)-derived muscle cross-sectional area (CSA), radiodensity, and skeletal muscle index (SMI) and dual energy X-ray absorptiometry (DXA) parameters with functional performance in cancer patients.

Materials and Methods: Handgrip strength, stair climb power (SCP), one-repetition maximum (1RM) strength, and body composition (CT and DXA) were compared across cancer patients with cachexia (CAC; N = 28), without cachexia (CNC; N = 28), and non-cancer patients (CON; N = 19). Multivariate regression was performed to find predictors of function.

Results: CAC had lower CT muscle CSA and SMI and lower DXA appendicular lean mass (ALM) than CNC or CON (p ≤ 0.011). Muscle radiodensity was not different across groups despite larger proportion of low CT SMI in CAC, and CAC performed worse in SCP than CON (p = 0.018). In cancer patients, DXA ALM and CT muscle CSA each predicted physical function (p ≤ 0.05); muscle radiodensity did not, and DXA ALM explained more variability in SCP and 1RM than CT muscle CSA.

Conclusions: Stair climb power was reduced in cancer cachexia; muscle radiodensity was not. Muscle mass by CT or DXA, but not radiodensity, predicted functional performance in cancer patients.


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