Sarcopenia Beyond Quantitative Assessment: The Quality Of Skeletal Muscle Mass Is Associated With Nutritional Status And One-Year Survival In Endometrial Cancer Patients

Gabriela CHAVES, Brazilian National Cancer Institute, Brazil

1 Department of Nutrition and Dietetics, Brazilian National Cancer Institute, Brazil.

Purposes: Myosteatosis, the excess deposition of triglycerides within skeletal muscle is associated with poor prognosis. Computed tomography (CT) scans are useful to quantify macroscopic accumulations of intermuscular fat. There is increasing evidence linking sarcopenia and cancer prognosis, despite no studies have evaluated, to date, the role of myosteatosis in cancer patients outcomes. The aim of the present study was to describe the relation with sarcopenia and myosteatosis with nutritional status and one-year survival in endometrial cancer (EC) patients.
Methods: a database was created, comprising EC patients who underwent oncological treatment at Brazilian National Cancer Institute between 2008-2014 and had a CT scan available within 30 days before treatment. Clinicopathological features and one-year survival were retrospectively collected from medical records. Skeletal muscle index (SMI) was calculated considering the range -29 to +150 HU measured on the CT scans, and reduced attenuation muscle in range -29 to +29 HU was classified as myosteatosis. By subtracting the myosteatosis area from total SMI, we created a new index designated "SMI free of myosteatosis" (SMIfree), as and indicator of high quality muscle area. Body mass index (BMI) were also assessed to classify nutritional status. One-year survival were evaluated by Kaplan-Meier method. Variables were considered statistical significant when p<0.05.
Results: 212 women with EC were included. Median age was 65 years-old. Median of SMIfree was significantly reduced in patients with sarcopenia. Obese women (BMI > 30Kg/ m²) had the higher amount of myosteatosis (51% >P50) and sarcopenic women had the lower amount of SMIfree  (41.3% Conclusions: The quality of skeletal muscle mass is a promising predictor of prognosis in cancer patients, although more studies are needed to confirm this association.
Funding: FAPERJ