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The Progressive Skeletal Muscle and Body Weight Loss in Cancer Patients

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A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (10 April 2023) | Viewed by 6219

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Prof. Dr. Eva Katharina Masel

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Guest Editor

Division of Palliative Medicine, Medical University of Vienna, 1090 Vienna, Austria
Interests: anxiety; cachexia; cancer care facilities; depression; dyspnea; humanities; nausea; pain; palliative care; psychiatry
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Christoph Wiltschke

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Guest Editor

University Clinic for Physical Medicine and Rehabilitation, Medical University of Vienna, 1090 Vienna, Austria
Interests: Antibody therapy; chemotherapy/systemic therapy; early breast cancer; hormone therapy; metastases

Special Issue Information

Cancer cachexia is defined as a syndrome characterised by anorexia, systemic inflammation, ongoing loss of muscle mass (with or without loss of fat mass), and weight loss, followed by a poor functional state and a limited ability to receive antineoplastic therapy. It is defined as weight loss greater than 5%, or weight loss greater than 2% in individuals showing a body-mass index (BMI) <20 kg/m² or loss of skeletal muscle mass (sarcopenia).

Cancer cachexia is estimated to affect up 50–80% of cancer patients, accounting up to 20% of cancer deaths. Negative protein and energy balance go hand in hand with reduced food intake and abnormal metabolism, leading to a complex pathophysiological process. Cachexia is classified in various stages, precachexia to cachexia to refractory cachexia. Still, there is no standard of care to manage cancer cachexia. Improvement in physical function seems crucial, as cancer cachexia cannot be fully reversed by conventional nutritional support.

This Special Issue should provide information upon assessment, catabolic drive, practice guidelines, clinical management, as well as pharmacologic and non-pharmacologic management of cancer cachexia.

Prof. Dr. Eva Katharina Masel
Prof. Dr. Christoph Wiltschke
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Cachexia
Diet Therapy
Medical Oncology
Nutritional Status
Nutrition Therapy
Palliative Care
Pharmacology
Physical Therapy Modalities
Rehabilitation

Published Papers (4 papers)

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Research

15 pages, 3108 KiB

Open AccessArticle

The Impact of Acute Systemic Inflammation Secondary to Oesophagectomy and Anastomotic Leak on Computed Tomography Body Composition Analyses

by Leo R. Brown, Michael I. Ramage, Ross D. Dolan, Judith Sayers, Nikki Bruce, Lachlan Dick, Sharukh Sami, Donald C. McMillan, Barry J. A. Laird, Stephen J. Wigmore and Richard J. E. Skipworth

Cancers 2023, 15(9), 2577; https://doi.org/10.3390/cancers15092577 - 30 Apr 2023

Viewed by 1433

Abstract

This study aimed to longitudinally assess CT body composition analyses in patients who experienced anastomotic leak post-oesophagectomy. Consecutive patients, between 1 January 2012 and 1 January 2022 were identified from a prospectively maintained database. Changes in computed tomography (CT) body composition at the third lumbar vertebral level (remote from the site of complication) were assessed across four time points where available: staging, pre-operative/post-neoadjuvant treatment, post-leak, and late follow-up. A total of 20 patients (median 65 years, 90% male) were included, with a total of 66 computed tomography (CT) scans analysed. Of these, 16 underwent neoadjuvant chemo(radio)therapy prior to oesophagectomy. Skeletal muscle index (SMI) was significantly reduced following neoadjuvant treatment (p < 0.001). Following the inflammatory response associated with surgery and anastomotic leak, a decrease in SMI (mean difference: −4.23 cm²/m², p < 0.001) was noted. Estimates of intramuscular and subcutaneous adipose tissue quantity conversely increased (both p < 0.001). Skeletal muscle density fell (mean difference: −5.42 HU, p = 0.049) while visceral and subcutaneous fat density were higher following anastomotic leak. Thus, all tissues trended towards the radiodensity of water. Although tissue radiodensity and subcutaneous fat area normalised on late follow-up scans, skeletal muscle index remained below pre-treatment levels. Full article

(This article belongs to the Special Issue The Progressive Skeletal Muscle and Body Weight Loss in Cancer Patients)

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11 pages, 1195 KiB

Open AccessArticle

Impact of Sex-Specific Preoperative Fat Mass Assessment on Long-Term Prognosis after Gastrectomy for Gastric Cancer

by Ryota Matsui, Noriyuki Inaki, Toshikatsu Tsuji and Tetsu Fukunaga

Cancers 2023, 15(7), 2100; https://doi.org/10.3390/cancers15072100 - 31 Mar 2023

Viewed by 1130

Abstract

We investigated the impact of the difference in fat distribution between men and women on long-term prognosis after gastrectomy in patients with advanced gastric cancer. Patients with advanced gastric cancer deeper than p-T2 who underwent gastrectomy between April 2008 and June 2018 were included. Visceral fat mass index (VFI) and subcutaneous fat mass index (SFI) were calculated by dividing the cross-sectional area at the umbilical level by the height squared. The medians of VFI and SFI by sex were defined as cut-off values, below which values were defined as low VFI and low SFI. Of the 485 patients, 323 (66.6%) were men and 162 (33.4%) were women. Men with a low VFI had a significantly worse overall survival (OS) (p = 0.004) and women with a low SFI had a significantly worse OS (p = 0.007). Patients with a low VFI and low SFI had the worst prognosis. Multivariate analysis showed that a low VFI was an independent poor prognostic factor in men, while a low SFI was an independent poor prognostic factor in women. In conclusion, a low visceral fat mass in men and a low subcutaneous fat mass in women were independent poor prognostic factors after radical gastrectomy for advanced gastric cancer. Full article

(This article belongs to the Special Issue The Progressive Skeletal Muscle and Body Weight Loss in Cancer Patients)

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20 pages, 1274 KiB

Open AccessArticle

Psycho-Educational and Rehabilitative Intervention to Manage Cancer Cachexia (PRICC) for Advanced Patients and Their Caregivers: Lessons Learned from a Single-Arm Feasibility Trial

by Loredana Buonaccorso, Stefania Fugazzaro, Cristina Autelitano, Elisabetta Bertocchi, Monia Allisen Accogli, Monica Denti, Stefania Costi, Gianfranco Martucci, Luca Braglia, Maria Chiara Bassi and Silvia Tanzi

Cancers 2023, 15(7), 2063; https://doi.org/10.3390/cancers15072063 - 30 Mar 2023

Cited by 2 | Viewed by 1642

Abstract

Background: Key elements in cancer cachexia (CC) management are personalized and multimodal interventions, but it is hard for some patients to follow programs based on several components. We examined the feasibility of a bimodal intervention, including a psycho-educational component and exercises, to support patients and their caregivers in managing CC; Methods: Prospective mixed-methods pilot study explored feasibility data, changes in patient-reported outcomes, and performance outcomes over time in a convenient sample of 30 consecutive CC patients and their caregivers. Results: Twenty-four dyads consented to participate. Twenty dyads received at least two psycho-educational sessions, so the psycho-educational component was feasible for 83.3% of the sample. Six dyads participated in at least fourteen out of twenty-seven rehabilitation sessions, so the exercise program was feasible for 25.0% of the sample. Six dyads showed compliance greater than 50% for both components of the bimodal intervention. Conclusions: While we did not meet our primary feasibility endpoint and had mixed acceptability, our experience provides insight into the challenges and lessons learned in implementing a primary palliative care intervention for CC. More robust studies are needed to help clinicians understand the best exercise program for CC patients, to be included in a multimodal intervention. Full article

(This article belongs to the Special Issue The Progressive Skeletal Muscle and Body Weight Loss in Cancer Patients)

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14 pages, 1088 KiB

Open AccessArticle

by Rianne N. M. Hogenbirk, Judith E. K. R. Hentzen, Willemijn Y. van der Plas, Marjo J. E. Campmans-Kuijpers, Schelto Kruijff and Joost M. Klaase

Cancers 2023, 15(3), 969; https://doi.org/10.3390/cancers15030969 - 03 Feb 2023

Viewed by 1580

Abstract

To study the occurrence of surgery-related muscle loss (SRML) and its association with in-hospital nutritional intake, we conducted a prospective observational cohort study including patients who underwent pancreatic surgery because of (suspected) malignant diseases. Muscle diameter was measured by using bedside ultrasound 1 day prior to surgery and 7 days postoperatively. Clinically relevant SRML was defined as ≥10% muscle diameter loss in minimally one arm and leg muscle within 1 week after surgery. Protein and caloric intake was measured by nutritional diaries. The primary endpoint included the number of patients with SRML. Secondary endpoints included the association between SRML and postoperative nutritional intake. Of the 63 included patients (60.3% men; age 67.1 ± 10.2 years), a total of 24 patients (38.1%) showed SRML. No differences were observed in severe complication rate or length of hospital stay between patients with and without SRML. During the first postoperative week, patients with clinically relevant SRML experienced more days without any nutritional intake compared with the non-SRML group (1 [0–4] versus 0 [0–1] days, p = 0.007). Significantly lower nutritional intake was found in the SRML group at postoperative days 2, 3 and 5 (p < 0.05). Since this study shows that SRML occurred in 38.1% of the patients and most of the patients failed to reach internationally set nutritional goals, it is suggested that more awareness concerning direct postoperative nutritional intake is needed in our surgical community. Full article

(This article belongs to the Special Issue The Progressive Skeletal Muscle and Body Weight Loss in Cancer Patients)

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