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Published on: March 21, 2021
Sarcopenia in Oncological Patients Diagnostics, Screening, and Impact on Quality of Life, Fatigue, Handgrip Strength,
Friederike Hilpert1, Lisa Jochem1, Lea Feline Kraack1
1Universitäres Cancer Center Schleswig-Holstein (UCCSH), Kiel, Germany.
Purpose:
The main objective of the Sarco-Detect study was to evaluate diagnostic tools-bioelectrical impedance analysis (BIA) and handgrip strength (HGS)-for determining sarcopenia compared with computed tomography (CT). The secondary aim was to evaluate the SARC-F questionnaire as a screening tool and to investigate the impact of muscle loss on quality of life, fatigue, HGS, and the association between previous physical activity and muscle loss.
Methods:
The study was conducted at the University Cancer Center Schleswig-Holstein. To assess muscle mass status, BIA and HGS were measured in patients with cancer and compared with CT. Additionally, EORTC QLQ-C30, FACIT-Fatigue Scale, BSA, and SARC-F questionnaires were administered.
Results:
One hundred thirty one patients were recruited. Fourteen patients showed a CT-SMI below the reference values by Van der Werf et al. (2018). Thirteen patients showed reduced HGS. CT-SMI and HGS correlated significantly (r = 0.492, p = 0.001). The phase angle of the BIA correlated significantly with CT-SMI (r = 0.441, p = 0.001) and HGS (r = 0.493, p = 0.001). Patients with reduced HGS presented significantly higher appetite loss compared with patients with preserved HGS. Patients with preserved HGS showed a higher quality of life than patients with reduced HGS. FACIT-Fatigue scores differed significantly between patients with reduced HGS and those with preserved HGS (F(1, 104) = 3.991, p = 0.048; U = 321.000, Z = -2.088, p = 0.037). Activity index correlated moderately with fatigue symptoms and quality of life. The SARC-F showed a sensitivity of 18.8% and specificity of 96.6% for HGS, and a sensitivity of 31.3% and specificity of 90.7% for CT-SMI.
Conclusions:
CT-SMI and HGS correlated positively and significantly. The BIA phase angle correlated with CT-SMI and HGS. Reduced HGS is associated with increased appetite loss, higher fatigue, and lower quality of life. SARC-F questionnaire appears suitable for identifying patients without sarcopenia.
Trial Registration:
German Clinical Trials Register: DRKS00035258.
