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Cited by 2,680

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index

Martin, Lisa, Birdsell, Laura, MacDonald, Neil, Reiman, Tony, Clandinin, M. Thomas, McCargar, Linda J., Murphy, Rachel, Ghosh, Sunita, Sawyer, Michael B., Baracos, Vickie E.·2013·Journal of Clinical Oncology
DOI 10.1200/jco.2012.45.2722
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Abstract

Purpose: Emerging evidence suggests muscle depletion predicts survival of patients with cancer. Patients and Methods: At a cancer center in Alberta, Canada, consecutive patients with cancer (lung or GI; N = 1,473) were assessed at presentation for weight loss history, lumbar skeletal muscle index, and mean muscle attenuation (Hounsfield units) by computed tomography (CT). Univariate and multivariate analyses were conducted. Concordance (c) statistics were used to test predictive accuracy of survival models. Results: Body mass index (BMI) distribution was 17% obese, 35% overweight, 36% normal weight, and 12% underweight. Patients in all BMI categories varied widely in weight loss, muscle index, and muscle attenuation. Thresholds defining associations between these three variables and survival were determined using optimal stratification. High weight loss, low muscle index, and low muscle attenuation were independently prognostic of survival. A survival model containing conventional covariates (cancer diagnosis, stage, age, performance status) gave a c statistic of 0.73 (95% CI, 0.67 to 0.79), whereas a model ignoring conventional variables and including only BMI, weight loss, muscle index, and muscle attenuation gave a c statistic of 0.92 (95% CI, 0.88 to 0.95; P < .001). Patients who possessed all three of these poor prognostic variables survived 8.4 months (95% CI, 6.5 to 10.3), regardless of whether they presented as obese, overweight, normal weight, or underweight, in contrast to patients who had none of these features, who survived 28.4 months (95% CI, 24.2 to 32.6; P < .001). Conclusion: CT images reveal otherwise occult muscle depletion. Patients with cancer who are cachexic by the conventional criterion (involuntary weight loss) and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight.

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  1. Payette H, 2000, J Nutr Health Aging, 4, 223

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Metadata

Authors
Martin, L., Birdsell, L., MacDonald, N., Reiman, T., Clandinin, M. T., McCargar, L. J., Murphy, R., Ghosh, S., Sawyer, M. B., & Baracos, V. E.
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2013-04-20
Volume
31
Issue
12
Pages
1539-1547
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2012.45.2722
OpenAlex
W2118558111
Cited by
2,680
References
32
FWCI
55.29
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index. https://app.cochat.ai/papers/10.1200/jco.2012.45.2722
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Martin, L., Birdsell, L., MacDonald, N., Reiman, T., Clandinin, M. T., McCargar, L. J., Murphy, R., Ghosh, S., Sawyer, M. B., & Baracos, V. E. (2013). Cancer Cachexia in the Age of Obesity: Skeletal Muscle Depletion Is a Powerful Prognostic Factor, Independent of Body Mass Index. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2012.45.2722

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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