Rapid Fire Best of the Best Oral 2025 Joint Meeting of the COSA ASM and IPOS Congress

Exploring potential predictors of low muscle mass and muscle loss in adults with cancer: A scoping review (126247)

Annie R Curtis 1 , Carla M Prado 2 , Liliana Orellana 3 , Robin M Daly 4 , Judy Bauer 5 , Linda Denehy 6 7 8 , Lara Edbrooke 6 7 8 , Brenton J Baguley 4 9 , Laura Alston 10 11 , Nick Hardcastle 12 , Jenelle Loeliger 4 8 9 , Louise Moodie 13 , Sharad Sharma 14 , Nicole Kiss 4 9
  1. Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
  2. Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
  3. Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
  4. Institute for Physical Activity and Nutrition , Deakin University, Geelong, VIC, Australia
  5. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
  6. Physiotherapy Department, University of Melbourne, Parkville, Melbourne, Australia
  7. Centre for Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  8. Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
  9. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  10. Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
  11. Research Unit, Colac Area Health, Colac, Victoria, Australia
  12. Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  13. Mackay Hospital and Health Service, Mackay, Queensland, Australia
  14. Department of Medical Oncology, Grampians Health, Ballarat, Victoria, Australia

Objectives: Early identification of cancer-related muscle loss is essential to enable timely interventions and mitigate adverse outcomes, including mortality. This scoping review aimed to identify predictors of cancer-related muscle loss, focusing on factors routinely assessed in clinical practice, to inform future screening and assessment efforts globally.

Procedures: Medline Complete, CINAHL Complete and Embase databases were screened up to October 2024. Studies were eligible if they investigated predictors of cancer-related muscle loss, included adults undergoing or previously treated for cancer, and assessed or estimated muscle mass.   

Results: The search identified 22,270 studies, 292 met the inclusion criteria. Studies most commonly included patients with upper and/or lower gastrointestinal cancers (47%), undergoing surgery (36%) or chemotherapy (27%). Most (65%) studies assessed muscle mass using computed tomography (CT) defined skeletal muscle mass at the third lumbar vertebra. Other methods included CT-defined single muscle mass (e.g., psoas) (15%), bioelectrical impedance analysis or spectrometry (12%), dual-energy x-ray absorptiometry (7%) or other (3%). As the benchmark for muscle mass assessment in oncology, results focused on CT-defined muscle loss, with comparisons to other methods if findings differed. In total, 20 predictors of cancer-related muscle loss were identified. Twelve showed a consistent negative association with CT-defined muscle loss in uni- or multivariate analysis: older age, lower BMI, performance status, body fat, physical function (e.g., gait speed), body weight, muscle strength, energy intake, protein intake, arm or leg circumference, weight loss, and physical inactivity. In multivariate analysis alone: BMI, physical function and protein intake remained consistently negatively associated with CT-defined muscle loss.

Conclusions and clinical implications: Valid screening tools for cancer-related muscle loss are currently lacking, but this review identified factors which may help identify patients at risk and requiring further assessment or timely referral for evidence-based nutrition and exercise treatment.