Impact of weight loss and sarcopenia on response to chemotherapy, quality of life and survival.

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Ryan, Aoife M.
Prado, Carla M.
Sullivan, Erin S.
Power, Derek G.
Daly, Louise E.
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The prevalence of malnutrition in patients with cancer has frequently been shown to be one of the highest of all hospital patient groups. Weight loss is a frequent manifestation of malnutrition in patients with cancer. Several large-scale studies over the last 35 years have reported that involuntary weight loss affects 50-80% of these patients with the degree of weight loss dependent on tumour site, type and stage of disease. This review will focus on the consequences of malnutrition, weight loss and muscle wasting in relation to chemotherapy tolerance, post-operative complications, quality of life and survival in oncology patients. The prognostic impact of weight loss on overall survival has long been recognised with recent data suggesting losses as little as 2.4% predicts survival independent of disease, site, stage or performance score. Recently the use of gold-standard methods of body composition assessment, including computed tomography, have led to an increased understanding of the importance of muscle abnormalities, such as low muscle mass (sarcopenia), and more recently low muscle attenuation, as important prognostic indicators of unfavourable outcomes in patients with cancer. Muscle abnormalities are highly prevalent (ranging from 10-90%, depending on cancer site and the diagnostic criteria used). Both low muscle mass and low muscle attenuation have been associated with poorer tolerance to chemotherapy; increased risk of postoperative complications; significant deterioration in a patients' performance status, and poorer psychological well-being, overall quality of life, and survival.
Sarcopenia , Cachexia , Chemotherapy , Quality of life , Survival , Malnutrition , Wasting , Cancer
Ryan, A. M., Prado, C. M., Sullivan, E. S., Power, D. G. and Daly, L. E. (2019) 'Impact of weight loss and sarcopenia on response to chemotherapy, quality of life and survival', Nutrition, In Press, doi: 10.1016/j.nut.2019.06.020