KEY TAKEAWAYS
- The study aimed to investigate the impact of sarcopenia and frailty on clinical outcomes in surgically treated patients with brain metastases.
- Researchers noticed that psoas cross-sectional area and post-operative CFS predict mortality and recurrence in patients with brain metastases, aiding in risk assessment.
Studies suggest that sarcopenia and frailty are linked to worse outcomes in cancer, including increased mortality and longer hospital stays. However, there’s a lack of data on how these conditions specifically impact patients diagnosed with brain cancer.
Mervyn Jun Rui Lim and the team aimed to delve into how sarcopenia and frailty influence clinical outcomes among patients undergoing surgical treatment for brain metastases.
Researchers performed an inclusive analysis encompassing patients who underwent surgical resection of brain metastases from 2011 to 2019. Psoas cross-sectional area and temporalis thickness were meticulously measured by two independent radiologists, ensuring high reliability (Cronbach’s alpha > 0.98). Frailty assessment was conducted using the Clinical Frailty Scale (CFS) pre-operatively and post-operatively.
The study collected data on overall mortality, recurrence, and duration of hospitalization. Cox regression was employed to analyze mortality and recurrence, while multiple linear regression was utilized to investigate the duration of hospitalization.
About 145 patients, with a median age of 60.0 years and 52.4% female, were included in the study. Psoas cross-sectional area emerged as an independent risk factor for overall mortality (HR = 2.68, 95% CI 1.64–4.38, P < 0.001) and recurrence (HR = 2.31, 95% CI 1.14–4.65, P = 0.020).
Post-operative CFS was identified as an independent risk factor for overall mortality (HR = 1.88, 95% CI 1.14–3.09, P = 0.013). Additionally, post-operative CFS (β = 15.69, 95% CI 7.67–23.72, P < 0.001) and increase in CFS (β = 11.71, 95% CI 3.91–19.51, P = 0.004) were associated with prolonged hospitalization duration.
The study concluded that for patients undergoing surgical treatment of brain metastases, psoas cross-sectional area is an independent predictor for mortality and recurrence, whereas post-operative CFS emerged as a significant risk factor for mortality. Moreover, post-operative frailty and increases in CFS were associated with prolonged hospitalization duration.
These findings underscore the potential utility of measuring psoas cross-sectional area and CFS in the risk stratification of surgical candidates for brain metastases.
The study received no funds.
Source: https://link.springer.com/article/10.1007/s11060-023-04542-w#Abs1
Lim, M.J.R., Zhang, Z., Zheng, Y., et al. (2024) “Effect of sarcopenia and frailty on outcomes among patients with brain metastases.” J Neurooncol 167, 169–180 (2024). https://doi.org/10.1007/s11060-023-04542-w
