Assessing Sarcopenia in Advanced‐Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy: A Case Series

Author:

Schofield Christelle12ORCID,Taaffe Dennis R.12,Newton Robert U.12,Galvão Daniel A.12,Cohen Paul A.34,Kim Jin‐Soo12,Meniawy Tarek2345,Peddle‐McIntyre Carolyn12

Affiliation:

1. Exercise Medicine Research Institute Edith Cowan University Joondalup Western Australia Australia

2. School of Medical and Health Sciences Edith Cowan University Joondalup Western Australia Australia

3. School of Medicine University of Western Australia Crawley Western Australia Australia

4. St John of God Hospital Subiaco Western Australia Australia

5. Sir Charles Gairdner Hospital Nedlands Western Australia Australia

Abstract

ABSTRACTObjectivesIn ovarian and other cancers, low muscle mass and density are associated with poorer clinical outcomes. However, screening for cancer‐related sarcopenia (typically defined as low muscle mass) is not routinely conducted. The European Working Group on Sarcopenia in Older People (EWGSOP) recommends an algorithm for sarcopenia screening and diagnosis in clinical settings, with sarcopenia based on muscle strength and mass, and severity on physical performance. We explored the application of the EWGSOP2 algorithm to assess sarcopenia in six ovarian cancer patients receiving neoadjuvant chemotherapy.MethodsWe assessed sarcopenia risk with the SARC‐F screening questionnaire (at risk ≥4 points), muscle strength with a handgrip strength test (cut point <16 kg) and five times sit‐to‐stand test (cut point >15 s), muscle mass by skeletal muscle index (SMI in cm2/m2 from a single computed tomography [CT] image; cut point <38.5 cm2/m2), and physical performance with a 4‐m gait speed test (cut point ≤0.8 m/s).ResultsOf six participants, none were identified as “at risk” for sarcopenia based on SARC‐F scores. Two participants were severely sarcopenic based on EWGSOP2 criteria (had low muscle strength, mass, and physical performance), and five participants were sarcopenic based on muscle mass only.DiscussionOvarian cancer patients with low muscle mass during neoadjuvant chemotherapy may not be identified as sarcopenic based on the EWGSOP2 diagnostic algorithm. While lacking a universally accepted definition for cancer‐related sarcopenia and cancer‐specific recommendations for the screening, diagnosis, and treatment of sarcopenia, ovarian cancer clinicians should focus on the diagnosis and treatment of low muscle mass and density.

Publisher

Wiley

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