Sarcopenia is a prognostic outcome marker in children with high-risk hepatoblastoma

Ritz, Annika; Kolorz, Julian; Hubertus, Jochen; Ley-Zaporozhan, Julia; von Schweinitz, Dietrich; Koletzko, Sibylle; Häberle, Beate; Schmid, Irene; Kappler, Roland; Berger, Michael und Lurz, Eberhard (2021): Sarcopenia is a prognostic outcome marker in children with high-risk hepatoblastoma. In: Pediatric Blood & Cancer, Bd. 68, Nr. 5, e28862

Abstract

Background Children with hepatoblastoma (HB) are at risk of sarcopenia due to immobility, chemotherapy, and malnutrition. We hypothesized that children with HB have a low preoperative total psoas muscle area (tPMA), reflecting sarcopenia, which negatively impacts outcome. Procedure Retrospective study of children (1-10 years) with hepatoblastoma treated at a large university children's hospital from 2009 to 2018. tPMA was measured as the sum of the right and left psoas muscle area (PMA) at intervertebral disc levels L3-4 and L4-5. z-Scores were calculated using age- and gender-specific reference values and were compared to anthropometric measurements, clinical variables, and outcomes. Sarcopenia was defined as a tPMA z-score below -2. Results Thirty-three children were included. Mean tPMA z-score was -2.18 +/- 1.08, and 52% were sarcopenic. A poor correlation between tPMA and weight was seen (r = 0.35;confidence interval [CI] 0.01, 0.62;P = .045), and most children had weights within the normal range (mean z-score -0.55 +/- 1.39). All children categorized as high risk with relapse (n = 5/12) were sarcopenic before surgery. Relapse was significantly higher in the high-risk sarcopenic group compared to the nonsarcopenic group (P = .008). The change in tPMA z-score 1-4 months after surgery did not improve in patients with relapse, but did improve in 75% of children without relapse. Conclusions The majority of children with HB were sarcopenic prior to surgery. Especially in children with high-risk hepatoblastoma, sarcopenia is an additional risk factor for relapse. Large multicenter studies are needed to confirm these preliminary results.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1545-5009
• Sprache: Englisch