Journal of geriatric oncology · 2026
Sarcopenia and early death in older patients with cancer: A secondary analysis of a prospective cohort.
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de Melo Silva Fernanda Rafaella, Souza Alex Sandro Rolland, de Mello Maria Júlia Gonçalves, Dos Santos Paloma Arquimedes Alves, Dos Santos Luiz Filipe Brasileiro Miranda, Fayh Ana Paula Trussardi, de Oliveira Lima Sales Jurema Telles
Аннотация
INTRODUCTION: Older adults with cancer have a higher risk of developing sarcopenia, which may contribute to a worse prognosis. This study aimed to verify if sarcopenia predicts early death in older adults with cancer at the time of admission for outpatient treatment.
MATERIALS AND METHODS: This prospective cohort study was based on secondary data analysis from individuals over 60 years old with cancer admitted to an oncogeriatric outpatient clinic from 2016 to 2020. Upon admission, sociodemographic data, clinical variables, nutritional, and physical assessment were evaluated. We considered probable sarcopenia (low hand grip strength [HGS], < 16 kg women and < 27 kg men), sarcopenia (low HGS and calf circumference [CC] < 31 cm), and severe sarcopenia (low HGS, decreased CC, and timed up and go test ≥20 s). The primary outcome was all-cause early death within 180 days from outpatient evaluation. A multivariate analysis using the Cox proportional hazards model was performed, and the survival curve was established according to the degrees of sarcopenia.
RESULTS: Of the 403 individuals included, 44.2% (n = 178) had some degree of sarcopenia upon admission (25.1% had probable sarcopenia and 15.6% had sarcopenia). Eighty-seven (21.6%) individuals died within 180 days. All degrees of sarcopenia were associated with death; probable sarcopenia (hazard ratio [HR] 1.76; confidence interval of 95% [95% CI] 1.05 to 2.99; p = 0.03), sarcopenia (HR 2.00; 95% CI 1.11 to 3.62; p = 0.02), and severe sarcopenia (HR 3.15; 95% CI 1.35 to 7.32; p = 0.007). Low HGS was the only criterion for diagnosing sarcopenia associated with early death. The other risk factors associated with death were male sex, primary site of cancer, metastatic disease, reduced functionality, and polypharmacy.
DISCUSSION: Identifying predictors of early death in older adults with cancer is clinically relevant and has a direct impact on therapeutic decision-making processes.
MATERIALS AND METHODS: This prospective cohort study was based on secondary data analysis from individuals over 60 years old with cancer admitted to an oncogeriatric outpatient clinic from 2016 to 2020. Upon admission, sociodemographic data, clinical variables, nutritional, and physical assessment were evaluated. We considered probable sarcopenia (low hand grip strength [HGS], < 16 kg women and < 27 kg men), sarcopenia (low HGS and calf circumference [CC] < 31 cm), and severe sarcopenia (low HGS, decreased CC, and timed up and go test ≥20 s). The primary outcome was all-cause early death within 180 days from outpatient evaluation. A multivariate analysis using the Cox proportional hazards model was performed, and the survival curve was established according to the degrees of sarcopenia.
RESULTS: Of the 403 individuals included, 44.2% (n = 178) had some degree of sarcopenia upon admission (25.1% had probable sarcopenia and 15.6% had sarcopenia). Eighty-seven (21.6%) individuals died within 180 days. All degrees of sarcopenia were associated with death; probable sarcopenia (hazard ratio [HR] 1.76; confidence interval of 95% [95% CI] 1.05 to 2.99; p = 0.03), sarcopenia (HR 2.00; 95% CI 1.11 to 3.62; p = 0.02), and severe sarcopenia (HR 3.15; 95% CI 1.35 to 7.32; p = 0.007). Low HGS was the only criterion for diagnosing sarcopenia associated with early death. The other risk factors associated with death were male sex, primary site of cancer, metastatic disease, reduced functionality, and polypharmacy.
DISCUSSION: Identifying predictors of early death in older adults with cancer is clinically relevant and has a direct impact on therapeutic decision-making processes.