Background Sarcopenia,as diagnosed by the former EWGSOP1 guidelines,was prevalent in cancer patients.The aim of this study was to examine the diagnostic capabilities of the previous and current guidelines,and to compa...Background Sarcopenia,as diagnosed by the former EWGSOP1 guidelines,was prevalent in cancer patients.The aim of this study was to examine the diagnostic capabilities of the previous and current guidelines,and to compare the clinicopathological features between patients diagnosed using the algorithms comprising the EWGSOP1 and EWGSOP2 guidelines.Methods We conducted a study including colorectal cancer patients from July 2014 to July 2019.The skeletal muscle mass,muscle attenuation,handgrip strength,and 6-meter usual gait speed were prospectively measured to define sarcopenia once patients were hospitalized.Results Of a total of 840 patients,160(19.0%)patients were diagnosed with sarcopenia based on the EWGSOP1 and 241(28.7%)patients were diagnosed based on the EWGSOP2.The numbers of patients diagnosed with sarcopenia and severe sarcopenia were much higher when the EWGSOP2 guidelines were used(160 vs.241 and 74 vs.140,respectively).The patients with EWGSOP2-defined sarcopenia showed a lower plasma albumin concentration(37.4 vs.36.4,P=0.039)but higher BMI(21.01 vs.22.22,P<0.001)than the patient diagnosed based on the EWGSOP1 guidelines.Conclusion The diagnosis of sarcopenia based on screening using the EWGSOP1 and EWGSOP2 guidelines differs considerably,at least in patients with colorectal cancer.In addition,the patients with EWGSOP2-diagnosed sarcopenia also showed a trend toward a lower plasma albumin level and higher BMI.展开更多
BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatme...BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatment.However,previous research reported widely differing sarcopenia prevalence due to different criteria.AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.METHODS An observational study was conducted from July 2014 to January 2017,which included 648 consecutive gastric cancer patients who underwent radical gastrectomy.The sarcopenia elements(skeletal muscle index,handgrip strength,and gait speed)were measured within 1 mo or 7 d before surgery.The patients were followed at fixed intervals to gain the outcomes.Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately.The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index(C-index)and area under the time-dependent receiver operating characteristic curve(AUC).The Akaike information criterion(AIC)was applied to compare model fits.RESULTS The prevalence of sarcopenia was 20.5%and 11.3%according to AWGS2019 and EWGSOP2,respectively.Sarcopenia was an independent risk factor for the longterm OS no matter based on AWGS2019 or EWGSOP2,but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio(HR)[2.150(1.547-2.988)]than EWGSOP2-sarcopenia[HR 1.599(1.092-2.339)].Meanwhile,the model with AWGS2019-sarcopenia[C-index 0.773(0.742-0.804);AIC 2193.7;time-dependent AUC 0.812(0.756-0.867)for 1-year OS,0.815(0.778-0.852)for 3-year OS,and 0.809(0.759-0.859)for 5-year OS]had better predictive power and model fits than the model with EWGSOP2-sarcopenia[C-index 0.762(0.729-0.795);AIC 2215.2;timedependent AUC 0.797(0.741-0.854)for 1-year OS,0.804(0.767-0.842)for 3-year OS,and 0.799(0.748-0.850)for 5-year OS].CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy.The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia.AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.展开更多
基金the National Natural Science Foundation of China(No.81800795).
文摘Background Sarcopenia,as diagnosed by the former EWGSOP1 guidelines,was prevalent in cancer patients.The aim of this study was to examine the diagnostic capabilities of the previous and current guidelines,and to compare the clinicopathological features between patients diagnosed using the algorithms comprising the EWGSOP1 and EWGSOP2 guidelines.Methods We conducted a study including colorectal cancer patients from July 2014 to July 2019.The skeletal muscle mass,muscle attenuation,handgrip strength,and 6-meter usual gait speed were prospectively measured to define sarcopenia once patients were hospitalized.Results Of a total of 840 patients,160(19.0%)patients were diagnosed with sarcopenia based on the EWGSOP1 and 241(28.7%)patients were diagnosed based on the EWGSOP2.The numbers of patients diagnosed with sarcopenia and severe sarcopenia were much higher when the EWGSOP2 guidelines were used(160 vs.241 and 74 vs.140,respectively).The patients with EWGSOP2-defined sarcopenia showed a lower plasma albumin concentration(37.4 vs.36.4,P=0.039)but higher BMI(21.01 vs.22.22,P<0.001)than the patient diagnosed based on the EWGSOP1 guidelines.Conclusion The diagnosis of sarcopenia based on screening using the EWGSOP1 and EWGSOP2 guidelines differs considerably,at least in patients with colorectal cancer.In addition,the patients with EWGSOP2-diagnosed sarcopenia also showed a trend toward a lower plasma albumin level and higher BMI.
基金Supported by Zhejiang Provincial Health Department Medical Support Discipline-Nutrition,No.11-ZC24Wenzhou Municipal Science and Bureau,No.Y2020732.
文摘BACKGROUND Sarcopenia is a nutrition-related disease and has a profound effect on the longterm overall survival(OS)of patients with gastric cancer.Its diagnostic criterion is critical to clinical diagnosis and treatment.However,previous research reported widely differing sarcopenia prevalence due to different criteria.AWGS2019 and EWGSOP2 are the two latest and widely adopted criteria.AIM To compare the effects of AWGS2019 and EWGSOP2 on the long-term OS of Chinese gastric cancer patient after radical gastrectomy.METHODS An observational study was conducted from July 2014 to January 2017,which included 648 consecutive gastric cancer patients who underwent radical gastrectomy.The sarcopenia elements(skeletal muscle index,handgrip strength,and gait speed)were measured within 1 mo or 7 d before surgery.The patients were followed at fixed intervals to gain the outcomes.Multivariate Cox regression analysis was performed to determine the association between sarcopenia and the long-term OS of these patients according to the two criteria separately.The predictive performance of the models with AWGS2019 and EWGSOP2 were evaluated by the concordance index(C-index)and area under the time-dependent receiver operating characteristic curve(AUC).The Akaike information criterion(AIC)was applied to compare model fits.RESULTS The prevalence of sarcopenia was 20.5%and 11.3%according to AWGS2019 and EWGSOP2,respectively.Sarcopenia was an independent risk factor for the longterm OS no matter based on AWGS2019 or EWGSOP2,but AWGS2019-sarcopenia in multivariate model had a higher hazard ratio(HR)[2.150(1.547-2.988)]than EWGSOP2-sarcopenia[HR 1.599(1.092-2.339)].Meanwhile,the model with AWGS2019-sarcopenia[C-index 0.773(0.742-0.804);AIC 2193.7;time-dependent AUC 0.812(0.756-0.867)for 1-year OS,0.815(0.778-0.852)for 3-year OS,and 0.809(0.759-0.859)for 5-year OS]had better predictive power and model fits than the model with EWGSOP2-sarcopenia[C-index 0.762(0.729-0.795);AIC 2215.2;timedependent AUC 0.797(0.741-0.854)for 1-year OS,0.804(0.767-0.842)for 3-year OS,and 0.799(0.748-0.850)for 5-year OS].CONCLUSION Sarcopenia is an independent risk factor for the long-term OS in Chinese gastric cancer patients undergoing radical gastrectomy.The prediction model with AWGS2019-sarcopenia has better predictive power and model fits than the prediction model with EWGSOP2-sarcopenia.AWGS2019 may be more appropriate for diagnosing sarcopenia in these Chinese patients than EWGSOP2.
