title: Loss of muscle mass in the end of life in patients with advanced cancer.
abstract: OBJECTIVE
  Muscle mass depletion is associated with adverse outcomes in cancer patients. There is limited information on the impact of age, sex, tumor type, and inflammation on muscle loss in the end of life of cancer patients.
  
  
  METHODS
  Muscle depletion and loss of muscle in the last 2 years of life was estimated in 471 cancer patients from 779 dual-energy X-ray absorptiometry scans. A linear mixed model was used to estimate the impact of age, sex, tumor type, and inflammation.
  
  
  RESULTS
  Patients above median age (>71 years) had less muscle mass (-1.1 ± 0.3 kg, P < 0.001). Prevalence of muscle depletion was higher in men than women (59 vs. 28%, P < 0.001). Men lost muscle mass over time (mean, 1.4 ± 0.3 kg/year, P < 0.001) contrary to women (0.3 ± 0.4 kg/year, P = 0.5). Patients with pancreatic cancer had less muscle mass than patients with biliary tract and colorectal cancers (P < 0.02). There were no differences in muscle loss over time in patients grouped by median age or tumor type. The prevalence of elevated C-reactive protein was 61 to 70% during the study. Patients with C-reactive protein >10 mg/L had less muscle mass (0.6 ± 0.2 kg, P < 0.001) and lost muscle mass at an accelerated pace during the disease trajectory (0.7 ± 0.3 kg/year, P = 0.03).
  
  
  CONCLUSIONS
  Muscle loss in advanced cancer is related to age, sex, tumor type, and inflammation. The mechanism(s) behind the apparent sexual dimorphism warrants further study.
authors: Department of Endocrinology, Diabetology and Metabolism, Sahlgrenska University Hospital, Dietistmotagningen, Per Dubbsgatan 14, 413 45, Gothenburg, Sweden, ola.wallengren@vgregion.se.
authors: Ola
authors: O
authors: Wallengren
authors: Britt-Marie
authors: BM
authors: Iresjö
authors: Kent
authors: K
authors: Lundholm
authors: Ingvar
authors: I
authors: Bosaeus
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000375:Aging; D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism; D002100:Cachexia / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009369:Neoplasms / Q000401:mortality / Q000473:pathology; D055948:Sarcopenia / Q000473:pathology*; D019452:Terminally Ill
chemical_list: D002097:C-Reactive Protein