Abstract

MIJAN DE LA TORRE, Alberto. Muscle wasting as a key predictor of survival in cancer patients. Nutr. Hosp. [online]. 2016, vol.33, suppl.1, pp.11-16. ISSN 1699-5198.

Cachexia syndrome has been estimated to be responsible for the death of a significant amount of cancer patients. It is characterized mainly by reduced intake, systemic inflammation and anomalous metabolism. Progressive loss of body weight, muscle wasting and functional impairment are remarkable features of the entity. Muscle wasting is due to a combination of both a diminution of protein synthesis and an increase in protein degradation. Progressive reduction of muscle protein drives to muscle fibre lessening and a reduction in its cross sectional area. Likewise, there is some evidence that a specific type of fiber is targeted in this setting. Defined cut points for sarcopenia are essential to diagnose skeletal muscle depletion and various methods have been carried out. The ubiquitin-proteasome pathway seems to play the main role in the breakdown of myofibrillar proteins. The trend to lose muscle in cancer cachexia patients may be associated to the triggering of catabolic signals by pro-inflammatory cytokines or tumour-specific agents such as proteolysis-inducing factor. Regarding prognostication, mortality risk is documented in sarcopenic cancer patients but is particularly accentuated in sarcopenic obese ones. A relationship between severe muscle depletion and survival has been shown in patients with different types of cancer such us pancreas, lung, biliary tract and colorrectal cancer. Therapeutic interventions for cancer cachexia syndrome are likely to require treatments from various groups including a combination of nutritional support, drugs with orexigenic, anabolic, anti-inflammatory effects and also non-pharmacologic interventions such as exercise.

Keywords : Cancer; Survival; Cachexia; Sarcopenia; Muscle wasting.

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