Phase Angle and Ultrasound Assessment of the Rectus Femoris for Predicting Malnutrition and Sarcopenia in Patients with Esophagogastric Cancer: A Cross-Sectional Pilot Study

Autores de IIS La Fe

• Erika Lexandra Vieira Maroun

  Autor

• María Argente Pla

  Autor

• Agustin Ramos Prol

  Autor

• Eva María Gascó Santana

  Autor

• Silvia Martin Sanchis

  Autor

• Angela Dura De Miguel

  Autor

• Andrea Micó García

  Autor

• Ana Cebrián Vázquez

  Autor

• Juan Francisco Merino Torres

  Autor

Participantes ajenos a IIS La Fe

• Pedraza Serrano M.J.
• Muresan B.T.
• Durbá Lacruz A.

Grupos

• Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética clínica

Abstract

Background: Disease-related malnutrition (DRM) and sarcopenia are prevalent conditions in gastrointestinal cancer patients, whose early diagnosis is essential to establish a nutritional treatment that contributes to optimizing adverse outcomes and improving prognosis. Phase angle (PhA) and rectus femoris ultrasound measurements are considered effort-independent markers of muscle wasting, which remains unrecognized in oncology patients. Objective: This study aimed to evaluate the potential utility of PhA, rectus femoris cross-sectional area (RFCSA), and rectus femoris thickness (RF-Y-axis) in predicting malnutrition and sarcopenia in patients with esophagogastric cancer (EGC). Methods: This was a cross-sectional study of patients diagnosed with EGC. PhA was obtained using bioelectrical impedance vector analysis (BIVA) along with ASMMI. The RFCSA and RF-Y-axis were measured using nutritional ultrasound (NU®). Muscle capacity was assessed using handgrip strength (HGS), and functionality by applying the Short Physical Performance Battery (SPPB). Malnutrition and sarcopenia were determined according to the GLIM and EWGSOP2 criteria, respectively. Results: Out of the 35 patients evaluated, 82.8% had malnutrition and 51.4% had sarcopenia. The RFCSA (r = 0.582) and RF-Y-axis (r = 0.602) showed significant, moderate correlations with ASMMI, unlike PhA (r = 0.439), which displayed a weak correlation with this parameter. However, PhA (OR = 0.167, CI 95%: 0.047–0.591, p = 0.006), RFCSA (OR = 0.212, CI 95%: 0.074–0.605, p = 0.004), and RF-Y-axis (OR = 0.002, CI 95%: 0.000–0.143, p = 0.004) all showed good predicting ability for sarcopenia in the crude models, but only the RF-Y-axis was able to explain malnutrition in the regression model (OR = 0.002, CI 95%: 0.000–0.418, p = 0.023). Conclusions: The RF-Y-axis emerged as the only independent predictor of both malnutrition and sarcopenia in this study, likely due to its stronger correlation with ASMMI compared to PhA and RFCSA. © 2024 by the authors.

Keywords

• Aged; Cross-Sectional Studies; Esophageal Neoplasms; Female; Hand Strength; Humans; Male; Malnutrition; Middle Aged; Nutrition Assessment; Nutritional Status; Pilot Projects; Quadriceps Muscle; Sarcopenia; Stomach Neoplasms; Ultrasonography; antineoplastic agent; adult; Article; bioelectrical impedance analysis; cancer chemotherapy; cancer patient; cancer radiotherapy; cancer surgery; clinical article; controlled study; cross-sectional study; echography; esophagus cancer; female; grip strength; human; male; malnutrition; middle aged; muscle thickness; nutritional assessment; phase angle; pilot study; prediction; radiological parameters; rectus femoris muscle; sarcopenia; screening; short physical performance battery; stomach cancer; aged; complication; diagnostic imaging; esophagus tumor; etiology; hand strength; malnutrition; nutritional status; pathophysiology; procedures; quadriceps femoris muscle; sarcopenia; stomach tumor