Área muscular abdominal determinada por tomografía computada como predictor de mortalidad en pacientes oncológicos

Abstract

Objective. To demonstrate that the current lumbar skeletal muscle index (LSMI) cutoff points overestimate sarcopenia in oncology patients. New cutoff points are proposed as predictors of mortality in oncology patients. Materials and methods: LSMI was estimated in a group of oncology and healthy patients on whom computed tomography was performed for oncological and non-oncological reasons, respectively. The prevalence of sarcopenia in the oncology group was determined using international cutoff points and cutoff points estimated from -1 SD and -2 SD below the average for healthy patients, recommending intermediate values to facilitate its use. A survival study was performed to demonstrate whether the cutoff points differ between mortality curves of sarcopenic and non-sarcopenic patients. Results: 131 healthy patients and 64 oncology patients were selected. The prevalence of sarcopenia in oncology patients was 80.8% and 42.1% with international cutoff points, 57.5% and 39.5% using -1 SD and 15.4% and 13.2% using -2 SD, in men and women respectively. During the follow-up, 17 patients died and the best predictor of mortality was LSMI of 45 cm2/m2 for men and 34 cm2/m2 for women. Conclusion: LSMI using cutoff points of 45 cm2/m2 for men and 34 cm2/m2 for women, is a good predictor of mortality.