Sarcopenia in Children and Adolescents With Cancer: A Systematic Review of Diagnostic Assessment Methods

Abstract

Sarcopenia, characterized by loss of muscle mass, strength decline, and impaired function, can affect patients with pediatric cancer. This systematic review aimed to identify diagnostic methods for sarcopenia and the associated clinical outcomes in this patient group. Procedure: PubMed, Embase, Scopus, Lilacs, and Scielo Library were searched on July 11, 2024, using the PICO strategy. Studies were considered eligible for inclusion if they were conducted on patients with pediatric cancer and if sarcopenia was diagnosed at any time during cancer treatment. The outcome variables studied were the diagnostic methods, prevalence of sarcopenia, and clinical outcomes associated with sarcopenia. Nineteen studies were included. The primary diagnostic method was the measurement of muscle mass, particularly focusing on the psoas muscle area, using imaging techniques, such as computed tomography and magnetic resonance imaging. Muscle strength and function were used as diagnostic criteria in four studies. The prevalence of sarcopenia ranged from 2.8% to 79%. Clinical outcomes frequently analyzed included mortality, postoperative complications, length of hospital stay, and overall survival. The primary diagnostic method for sarcopenia was the measurement of muscle mass using imaging techniques. Muscle strength and function were infrequently used as diagnostic criteria. The studies reported mixed results regarding the association between sarcopenia and clinical outcomes. There is a need for standardized diagnostic criteria that incorporate both muscle mass and function measurements, including handgrip strength, in pediatric oncology patients.