The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer

Authors

• Efthymios Papadopoulos, Louisiana State University School of Kinesiology, Baton Rouge, LA
• Andy Kin On Wong, University Health Network, Toronto, ON, Canada
• Sharon Hiu Ching Law, University Health Network, Toronto, ON, Canada
• Sarah Costa, University Health Network, Toronto, ON, Canada
• Angela M. Cheung, University Health Network, Toronto, ON, Canada
• Dmitry Rozenberg, University Health Network, Toronto, ON, Canada
• Shabbir M H Alibhai, University Health Network, Toronto, ON, Canada

Document Type

Article

Publication Date

12-6-2024

Publication Title

Current Oncology

Abstract

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, p = 0.037) and myosteatosis alone (aHR = 2.14, 95%CI = 1.07-4.30, p = 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.

First Page

7852

Last Page

7862

DOI

10.3390/curroncol31120578

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Papadopoulos, Efthymios; Wong, Andy Kin On; Law, Sharon Hiu Ching; Costa, Sarah; Cheung, Angela M.; Rozenberg, Dmitry; and Alibhai, Shabbir M H, "The Role of Frailty and Myosteatosis in Predicting All-Cause Mortality in Older Adults with Cancer" (2024). LSU-LCMC Cancer Center Faculty Publications. 193.
https://digitalscholar.lsuhsc.edu/llcc_facpubs/193
10.3390/curroncol31120578