Dados do Resumo

Título

PREVALENCE AND IMPACT OF SARCOPENIA IN ELDERLY CANCER PATIENTS: ASSESSMENT OF RISK FACTORS AND MANAGEMENT STRATEGIES

Introdução

The growing number of elderly cancer patients requires special and attentive care, combining various levels of treatment to achieve the best outcomes. Sarcopenia, a gradual loss of muscle mass common in older age, is a significant concern due to its association with fractures and loss of functionality. Its high prevalence among cancer patients highlights the need for personalized care for this vulnerable group.

Objetivo

Analyze the prevalence and impact of sarcopenia in elderly cancer patients, identifying risk factors and their consequences. Evaluate the effectiveness of current strategies for monitoring and treating malnutrition, sarcopenia, and cachexia, and explore integrating dietary measures and nutritional assessments to improve care and clinical outcomes.

Métodos

For this summary, two meta-analysis studies were reviewed. The first study's protocol was registered with PROSPERO and followed PRISMA guidelines. The research was conducted between December 6 and 8, 2018, covering databases such as Ovid MEDLINE, EMBASE, and Web of Science, with no restrictions on date or language. The initial search yielded 726 studies in PubMed, excluding publications prior to 2010. After review, 25 studies on risk factors and 109 on consequences were selected, with data extracted and reviewed by AB and GM. The second study involved a broad search across multiple databases, returning 5,997 articles. After evaluating 703 studies for eligibility, 42 were selected, including 21,032 participants, published between 2008 and 2019. This set included 14 potential studies, 24 retrospective cohorts, 2 cross-sectional studies, and 2 randomized controlled trials. Data screening and extraction were accompanied by quality assessments and bias risk evaluations.

Resultados

The studies revealed significant variation in the prevalence of sarcopenia, from 10% to 16% in general populations, reaching up to 66% in patients with unresectable esophageal cancer. Sarcopenia was associated with higher mortality, postoperative complications, and prolonged hospitalizations, as well as an increased risk of cognitive impairment, osteoporosis, and falls. Identified risk factors include overweight, obesity, smoking, and poor sleep quality, while physical activity and good nutrition were protective. In the second study, analysis of 42 articles and 21,032 participants demonstrated that low dietary intake is linked to worse clinical outcomes and increased mortality. However, current screening often fails to adequately assess dietary intake, indicating a need for further research to improve the diagnosis and treatment of malnutrition, cachexia, and sarcopenia.

Conclusões

Sarcopenia is prevalent among the elderly and those with various diseases, significantly increasing the risk of mortality and complications. Contributing factors include physical inactivity, malnutrition, and comorbidities. Most evidence comes from observational studies. For elderly cancer patients, no single effective tool exists to monitor malnutrition, sarcopenia, and cachexia, which often occur together. Integrating dietary intake assessments with nutritional analyses could be beneficial, but the optimal approach is yet to be established.

Palavras Chave

Sarcopenia; Nutrition; Oncology