Sami Antoun1, Caroline Rossoni2, Emilie Lanoy2,3. 1. Emergency Unit. 2. Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus. 3. University Paris-Saclay, University Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
Abstract
PURPOSE OF REVIEW: Cachexia (CAX), a protein metabolism disorder commonly associated with cancer, can be evaluated by computed tomography (CT) scan assessment of skeletal muscle mass (SMM), a parameter associated with patient outcome. This review analyzes current barriers for using CT scans of SMM in routine management for defining prognostic risk groups, and proposes new areas of research to reach a better understanding of CAX mechanisms. RECENT FINDINGS: Current research is focused on establishing a robust and relevant CAX staging system to reach a consensual definition. Previous biomarkers of CAX are poorly associated with outcome and do not exhibit clinical benefit. Systemic inflammatory marker, decrease in intake assessments, and/or nonnutritional criteria have been integrated to develop a multidimensional, highly complex CAX signature and CAX staging. SUMMARY: A standardized definition of sarcopenia is essential, and its value in clinical practice should be evaluated in prospective interventional studies using skeletal muscle assessment. SMM loss may be a key element in defining early protein disorders occurring before weight loss and could be used as a trigger for initiating early nutritional support. Changes in SMM and body composition during follow-up are useful tools for exploring CAX mechanisms in terms of intrinsic factors or tumor evolution.
PURPOSE OF REVIEW: Cachexia (CAX), a protein metabolism disorder commonly associated with cancer, can be evaluated by computed tomography (CT) scan assessment of skeletal muscle mass (SMM), a parameter associated with patient outcome. This review analyzes current barriers for using CT scans of SMM in routine management for defining prognostic risk groups, and proposes new areas of research to reach a better understanding of CAX mechanisms. RECENT FINDINGS: Current research is focused on establishing a robust and relevant CAX staging system to reach a consensual definition. Previous biomarkers of CAX are poorly associated with outcome and do not exhibit clinical benefit. Systemic inflammatory marker, decrease in intake assessments, and/or nonnutritional criteria have been integrated to develop a multidimensional, highly complex CAX signature and CAX staging. SUMMARY: A standardized definition of sarcopenia is essential, and its value in clinical practice should be evaluated in prospective interventional studies using skeletal muscle assessment. SMM loss may be a key element in defining early protein disorders occurring before weight loss and could be used as a trigger for initiating early nutritional support. Changes in SMM and body composition during follow-up are useful tools for exploring CAX mechanisms in terms of intrinsic factors or tumor evolution.
Authors: Sophie A Kurk; Rebecca K Stellato; Petra H M Peeters; Bram Dorresteijn; Marion Jourdan; Marieke J Oskam; Cornelis J A Punt; Miriam Koopman; Anne M May Journal: Am J Clin Nutr Date: 2019-12-01 Impact factor: 7.045
Authors: Wolfgang M Thaiss; Sergios Gatidis; Tina Sartorius; Jürgen Machann; Andreas Peter; Thomas K Eigentler; Konstantin Nikolaou; Bernd J Pichler; Manfred Kneilling Journal: Cancer Immunol Immunother Date: 2020-11-01 Impact factor: 6.968
Authors: Tara Catharina Mueller; Lilly Reik; Olga Prokopchuk; Helmut Friess; Marc Eric Martignoni Journal: Medicine (Baltimore) Date: 2020-12-11 Impact factor: 1.817