Table 2.
Summary of current research on sarcopenia in children with solid organ tumors.
| Author, Year | Cohort Size | Tumor Type | Age (Years) | Measurement Modality |
Markers for Muscle Mass |
Markers for Muscle Strength or Function |
Summary |
|---|---|---|---|---|---|---|---|
| Vatanen et al., 2017 [126] |
n = 19 | High-risk NB | median 22 (range 16–30) | DXA | Whole body LMI * | Strength: Sit-up test Function: Shuttle-run test § |
Survivors have a low LM and higher risk of frail health |
| Kawakubo et al., 2019 [127] | n = 13 | High-risk NB | PFS: mean 2 (range 0–5) R/D: mean 3.1 (range 2–5) |
CT | tPMA at L3 | During standard treatment, the rate of change increased in the progression-free survival group and decreased in the relapse and death group | |
| Joffe et al., 2020 [128] |
N = 39 (n = 8, 7, 16, 8, respectively) |
Ewing sarcoma, Osteosarcoma, Rhabdomyosarcoma, Wilms tumor |
median 11 (range 1.33–20) | CT | SMM at T12-L1 (n = 39), L3 (n = 22) |
After 6–12 weeks, skeletal muscle and residual lean tissue decreased and visceral adipose tissue increased | |
| Nakamura et al., 2021 [39] |
n = 24 | High-risk NB | median 2 (range 0–6) | CT | PMI † at L4 | During induction chemotherapy, the strongest reduction in PMI occurred at the beginning of chemotherapy and younger children and boys tended to show a recovery in PMI between the second and last measurements | |
| Guo et al., 2021 [117] |
n = 20 | High-risk NB | mean 12.4 ± SD 1.6 |
DXA | Leg LM, appendicular LM, total body LM (excluding bone mass) | Strength: isometric ankle dynamometry |
Survivors have a low leg LM and muscle strength |
| Ritz et al., 2021 [120] |
n = 101 | NB | median 3 (IQR 2.25–5) |
CT, MRI | tPMA at L3–4, 4–5 | Before surgery, the majority had tPMA z < −2 and pre-operative tPMA z < −2 risk factor for 5-year mortality, and girls have lower tPMA z-scores |
|
| Ijpma et al., 2021 [129] |
n = 29 | High-risk NB | median 3.0 (IQR 2.0–4.5) | CT | SMI ‡, skeletal muscle density at L3 | During treatment, skeletal muscle mass, skeletal muscle density, and intermuscular adipose tissue increased minimally and visceral and subcutaneous adipose tissue increased | |
| Ritz et al., 2021 [119] |
n = 33 | Hepatoblastoma | median 2.15 (IQR 1.47, 3.24) | CT, MRI | tPMA at L3–4, 4–5 | Before surgery, majority had tPMA z < −2; in high-risk HB, pre-operative tPMA z < −2 was a risk factor for relapse; and girls have lower tPMA z-scores | |
| Romano et al., 2022 [130] | n = 21 | Ewing Sarcoma, Rhabdomyosarcoma, Desmoplastic tumor |
median 10.5 (IQR 6.6, 15.1) | CT | tPMA at L4–5 | At diagnosis and after 1 year, majority had tPMA z < −1 and tPMA z decreased significantly after 1 year |
* lean mass (kg)/height (m2). † psoas muscle cross-sectional area (PMCSA, cm2)/body surface area (m2) = (PMCSA, cm2)/(square root of (height [cm] × weight [kg]/3600)). ‡ skeletal muscle cross-sectional area (cm2)/height (m2). § The purpose of this study was to assess for frailty, not sarcopenia. The shuttle-run test was used as a marker for slowness. The shuttle-run test could also be interpreted as a marker for muscle function (performance). Abbreviations: IQR, interquartile range; LM, lean mass; LMI, lean mass index; NB, neuroblastoma; PFS, progression-free survival; PMI, psoas muscle index; R/D, relapse/death; SD, standard deviation; SMM, skeletal muscle mass; SMI, skeletal muscle index; MUAC, mid-upper arm circumference; z, z-score