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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2020.tde-13042020-144056
Document
Author
Full name
Cecilia Helena Peinado de Sampaio Mattos
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Ferriolli, Eduardo (President)
Freitas, Ellen Cristini de
Peria, Fernanda Maris
Santos, André Filipe Junqueira dos
Title in Portuguese
Avaliação da massa muscular e da presença de sarcopenia em idosos oncológicos e sua associação com a avaliação geriátrica ampla
Keywords in Portuguese
Avaliação geriátrica ampla
Câncer
Idoso
Sarcopenia
Abstract in Portuguese
O comprometimento da massa muscular esquelética associada à redução de força muscular é frequente em oncologia e correlacionada à diminuição da qualidade de vida, falta de resposta à terapia antineoplásica e aumento da toxicidade, principalmente em idosos. O objetivo do estudo foi avaliar associação entre a reserva de massa muscular e sarcopenia pelos critérios do consenso revisado da European Working Group of Sarcopenia in Older Patients (EWGSOP2) com as variáveis da Avaliação Geriátrica Ampla (AGA). Foram incluídos 67 pacientes atendidos no Ambulatório de Oncogeriatria do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, com média de idade de 76,8 anos, sendo 33 homens e 34 mulheres. Os tumores mais frequentes na amostra foram mama, intestino, estômago e esôfago, em diferentes estágios da doença. A prevalência de baixo Índice de Massa Muscular (IMM) foi de 78,6%, enquanto a de sarcopenia, de 50%. De todas as variáveis da AGA avaliadas, a Força de Preensão Palmar (FPP) e a escala de Katz tiveram associação com baixo IMM e com a sarcopenia. Conclusão: Os resultados ressaltam a importância da avaliação geriátrica precoce na identificação da sarcopenia, para a possível reversão de comprometimentos funcionais e nutricionais e possibilitando a indicação e o planejamento adequado da terapia oncológica.
Title in English
Evaluation of muscle mass and presence of sarcopenia in older cancer patients and its association with comprehensive geriatric assessment
Keywords in English
Cancer
Elderly
Global geriatric assessment
Sarcopenia
Abstract in English
Sarcopenia is characterized by impairment of skeletal muscle mass and strength and a frequent finding in oncology, being associated with reduced quality of life, deficiency in response to treatment and increased toxicity, especially in the older patients. The aim of the present study was to evaluate the association of low muscle mass (LMM) and sarcopenia considering the revised european consensus published by the European Working Group on Sarcopenia in Older People (EWGSOP2) with the variables of the comprehensive geriatric assessment (CGA) in older oncological patients. For this propose, 67 patients (50.7% female; mean age of 76.8±7,93 years) treated at Oncogeriatric Outpatient Clinic of University Hospital were enrolled. Clinical data were obtained from electronic medical records and the skeletal muscle mass evaluation was performed using CT (in the height of the third lumbar vertebra). For LMM and sarcopenia classification, specific cutoff points were used. CGA variables were compared between LMM and Normal Muscle Mass (NMM) and between sarcopenic and non-sarcopenic individuals. The independent t test was employed for comparisons (R Core Team®, p<0.05). The most frequent tumors were breast, intestine, stomach and lung, at different stages of the disease. The prevalence of LMM was 78.6% and the prevalence of sarcopenia was 50%. Of all CGA variables evaluated, hand grip strength (16,53±6,46) and Katz (4,87±1,68) scale were related with LMM and sarcopenia. These results highlight the importance of early geriatric clinical evaluation of oncology older patients, considering its relation to low muscle mass and most important, to sarcopenia, for the possible reversal of functional and nutritional impairments and for the indication or appropriate planning of cancer therapy.
 
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Publishing Date
2020-04-29
 
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