Sarcopenia is a predictor of clinical outcomes in men with metastatic castrate-resistant prostate cancer (mCRPC); however, correlates and predictors of sarcopenia are poorly understood in this population. The aim of this study was to examine correlates and predictors of sarcopenia in men with mCRPC prior to treatment.
A secondary analysis of an observational study was performed. Participants were receiving care for mCRPC at the Princess Margaret Cancer Centre. Sarcopenia was assessed prior to treatment and was defined as the combination of low grip strength (<35.5 kg), low gait speed (<0.8 m/s), and computed tomography-derived low muscle mass or density. Participants' sociodemographic and clinical characteristics, comorbidity information, and clinically relevant blood markers were collected prior to treatment and were used to identify correlates and predictors of sarcopenia through Spearman correlations and multivariable logistic regression, respectively.
In total, 110 men had complete data on sarcopenia measures and were included in the analysis. Sarcopenia was identified in 30 (27.3%) participants. Pre-treatment sarcopenia was moderately correlated with dependence in one or more instrumental activities of daily living (IADLs) (r=0.412), Vulnerable Elders Survey-13 (r=0.404), and a lower hemoglobin (r=0.407 per 10 g/L decrease). In adjusted logistic regression, dependence in one or more IADLs (odds ratio [OR] 4.37, 95% confidence interval [CI] 1.37-13.86, p=0.012), and a 10 g/L decrease in hemoglobin (OR 1.70, 95% CI 1.13-2.57, p=0.012) were significantly associated with sarcopenia.
In settings where assessment of sarcopenia is not feasible, evaluation of IADLs and hemoglobin may be used to identify high-risk patients that can benefit from supportive care strategies aiming to improve muscle mass and function.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2024 Jul 15 [Epub ahead of print]
Efthymios Papadopoulos, Andy Kin On Wong, Sharon Hiu Ching Law, Lindsey Zhang, Henriette Breunis, Urban Emmenegger, Shabbir M H Alibhai
School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States., Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada., Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada., Department of Medicine, University Health Network, Toronto, ON, Canada., Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.