Journal
NUTRIENTS
Volume 14, Issue 2, Pages -Publisher
MDPI
DOI: 10.3390/nu14020383
Keywords
soft tissue sarcoma; bone sarcoma; pediatric patients; chemotherapy; psoas muscle area (PMA); sarcopenia; personalized medicine
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In this study, nutritional and sarcopenia status were assessed in pediatric patients with bone and soft tissue sarcomas. It was found that over half of the patients experienced sarcopenia at diagnosis, and there was a significant decrease in prognostic nutritional index (PNI) and total psoas muscle area (tPMA) after 12 months of treatment. Furthermore, a decrease in PNI was associated with poor overall survival (OS) in these patients.
Background: We evaluated nutritional and sarcopenia status and their clinical impact in pediatric patients affected by bone and soft tissue sarcomas. Methods: Body mass index (BMI), prognostic nutritional index (PNI), and total psoas muscle area (tPMA) at diagnosis and after 12 months were analyzed. tPMA was measured from single cross-sectional computed tomography (CT) images at L4-L5. Age-specific and sex-specific tPMA Z-scores were retrieved from an online calculator. Results: A total of 21 patients were identified between February 2013 and December 2018. Twelve patients (57.1%) experienced sarcopenia at diagnosis, although not statistically associated with overall survival (OS) (p = 0.09). BMI Z-score, PNI, and tPMA Z-score significantly decreased between diagnosis and after 12 months of treatment (p < 0.05). Univariate analysis showed significant associations between poor OS and the presence of metastasis (p = 0.008), the absence of surgery (p = 0.005), PNI decrease (p = 0.027), and the reduction in tPMA > 25% (p = 0.042) over the 12 months. Conclusions: Sarcopenia affects more than half of the patients at diagnosis. Decreased PNI during 12 months of treatment has significant predictive value for OS. The role of tPMA derived from CT scan among pediatric patients with sarcoma should be investigated in further prospective and larger studies.
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