Low calf circumference is an independent predictor of mortality in cancer patients: A prospective cohort study

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2020-11, Vol.79-80, p.110816-110816, Article 110816
• Main Authors: Sousa, Iasmin Matias, Bielemann, Renata Moraes, Gonzalez, Maria Cristina, da Rocha, Ilanna Marques Gomes, Barbalho, Erica Roberta, de Carvalho, Ana Lúcia Miranda, Dantas, Maria Amélia Marques, de Medeiros, Galtieri Otávio Cunha, Silva, Flavia Moraes, Fayh, Ana Paula Trussardi
• Format: Article
• Language: English
• Subjects: Age; Anthropometry; Ascites; Body mass index; Body measurements; Body size; Cancer; Chemotherapy; Cohort analysis; Computed tomography; Confidence intervals; Death; Disease; Edema; Evaluation; Gastric cancer; Medical imaging; Medical prognosis; Men; Mortality; Mortality risk; Muscle mass; Muscles; Musculoskeletal system; Nutritional status; Oncology; Overweight; Radiation therapy; Sarcopenia; Sex; Skeletal muscle; Skeletal muscle index; Software; Statistical models; Surgery; Vertebrae; Womens health
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2020.110816

•Low calf circumference can predict risk of mortality in patients with cancer.•Skeletal muscle index was not associated with mortality after confounder's adjustment.•Easy and cost-effective measurement to screen patients at risk and improve prognosis. Loss of muscle mass is associated with worse outcomes in patients with cancer. The objective of this study was to evaluate the prognostic value of calf circumference (CC) and skeletal muscle index from computed tomography (CT) to predict mortality in patients with cancer. A single-center prospective study was conducted with patients aged ≥20 y attending a reference center of oncology and who had recent abdominal CT images. Data were collected through a semistructured form and patients’ records and included sociodemographic data (sex, age and ethnicity), clinical data (primary site and staging of tumor and treatments performed), anthropometric variables (body mass index and CC), and outcome (death). Low CC for men was considered to be ≤ 34 cm and for women ≤ 33 cm. Muscle mass was assessed by CT images at the level of L3. The Cox proportional hazard model adjusted for age, sex, and staging of disease was used. A total of 250 patients were evaluated, 52.8% female, with a median age of 63 y (interquartile ratio: 55–73). Normal body mass index was identified in 44.4%; 29.2% had low skeletal muscle index, and 46.4% had low CC. Death by any cause occurred in 16%, and only low CC was a significant predictor of mortality (hazard ratio = 3.01; confidence interval 1.52–5.98; P = 0.002). Low CC can predict risk of mortality in this cohort of patients. The findings suggest the use of CC as a simple, easy, cost-effective anthropometric measurement to quickly screen patients at risk of death who could benefit from targeted care to improve their prognosis.