The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer
Frailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing chem...
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MDPI AG
2024-12-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/31/12/578 |
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| author | Efthymios Papadopoulos Andy Kin On Wong Sharon Hiu Ching Law Sarah Costa Angela M. Cheung Dmitry Rozenberg Shabbir M. H. Alibhai |
| author_facet | Efthymios Papadopoulos Andy Kin On Wong Sharon Hiu Ching Law Sarah Costa Angela M. Cheung Dmitry Rozenberg Shabbir M. H. Alibhai |
| author_sort | Efthymios Papadopoulos |
| collection | DOAJ |
| description | Frailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing chemotherapy. This was a retrospective study of older adults (≥65 years) initiating chemotherapy between June 2015 and June 2022. Frailty was assessed using a 24-item frailty index (FI). Myosteatosis was evaluated via computed tomography scans at the third lumbar vertebra (L3).. Multivariable Cox regression and Uno’s c-statistic determined the predictive performance of the FI and myosteatosis. In total, 115 participants (mean age: 77.1 years) were included. Frailty alone (adjusted hazards ratio (aHR) = 1.68, 95% confidence intervals (CIs) = 1.03–2.72, <i>p</i> = 0.037) and myosteatosis alone (aHR = 2.14, 95%CI = 1.07–4.30, <i>p</i> = 0.032) exhibited similar performance (c-statistic = 0.66) in predicting ACM in multivariable analyses adjusted for age, sex, body mass index, and treatment intent. However, the highest predictive performance for ACM was observed after inclusion of both myosteatosis and frailty in the multivariable model (c-statistic = 0.70). Myosteatosis improves the performance of frailty for predicting ACM in older adults with cancer. Prospective studies to assess the effect of exercise on myosteatosis in older patients are warranted. |
| format | Article |
| id | doaj-art-25fee3437e6247deafee6bd4ed037092 |
| institution | DOAJ |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-25fee3437e6247deafee6bd4ed0370922025-08-20T02:50:59ZengMDPI AGCurrent Oncology1198-00521718-77292024-12-0131127852786210.3390/curroncol31120578The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with CancerEfthymios Papadopoulos0Andy Kin On Wong1Sharon Hiu Ching Law2Sarah Costa3Angela M. Cheung4Dmitry Rozenberg5Shabbir M. H. Alibhai6School of Kinesiology, Louisiana State University, Baton Rouge, LA 70803, USACentre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network, Toronto, ON M5G 2C4, CanadaCentre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network, Toronto, ON M5G 2C4, CanadaCentre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network, Toronto, ON M5G 2C4, CanadaCentre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network, Toronto, ON M5G 2C4, CanadaToronto General Hospital Research Institute, University Health Network, Toronto, ON M5G 2C4, CanadaDepartment of Medicine, University Health Network, Toronto, ON M5G 2C4, CanadaFrailty and myosteatosis are each prognostic of all-cause mortality (ACM) in patients with cancer. However, it is unclear whether myosteatosis adds value to frailty for predicting ACM. We assessed whether myosteatosis improves the predictive ability of frailty for ACM in older adults undergoing chemotherapy. This was a retrospective study of older adults (≥65 years) initiating chemotherapy between June 2015 and June 2022. Frailty was assessed using a 24-item frailty index (FI). Myosteatosis was evaluated via computed tomography scans at the third lumbar vertebra (L3).. Multivariable Cox regression and Uno’s c-statistic determined the predictive performance of the FI and myosteatosis. In total, 115 participants (mean age: 77.1 years) were included. Frailty alone (adjusted hazards ratio (aHR) = 1.68, 95% confidence intervals (CIs) = 1.03–2.72, <i>p</i> = 0.037) and myosteatosis alone (aHR = 2.14, 95%CI = 1.07–4.30, <i>p</i> = 0.032) exhibited similar performance (c-statistic = 0.66) in predicting ACM in multivariable analyses adjusted for age, sex, body mass index, and treatment intent. However, the highest predictive performance for ACM was observed after inclusion of both myosteatosis and frailty in the multivariable model (c-statistic = 0.70). Myosteatosis improves the performance of frailty for predicting ACM in older adults with cancer. Prospective studies to assess the effect of exercise on myosteatosis in older patients are warranted.https://www.mdpi.com/1718-7729/31/12/578frailtymyosteatosismuscle densitysurvivalcancerolder adults |
| spellingShingle | Efthymios Papadopoulos Andy Kin On Wong Sharon Hiu Ching Law Sarah Costa Angela M. Cheung Dmitry Rozenberg Shabbir M. H. Alibhai The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer Current Oncology frailty myosteatosis muscle density survival cancer older adults |
| title | The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer |
| title_full | The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer |
| title_fullStr | The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer |
| title_full_unstemmed | The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer |
| title_short | The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer |
| title_sort | role of frailty and myosteatosis in predicting all cause mortality in older adults with cancer |
| topic | frailty myosteatosis muscle density survival cancer older adults |
| url | https://www.mdpi.com/1718-7729/31/12/578 |
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