Retroprospective evaluation of sarcopenia and the effect ofclinical monitoring in pediatric patients with solid organ tumors

Objectives: In our study, it was planned to detect sarcopenia in pediatric age group patients with solid organ tumors, to evaluate the effect of sarcopenia on clinical outcomes, the response of the chemotherapy, prognosis of cases and raise awareness of sarcopenia in the light of the data we obtained. Material and methods: In this study we scan 65 patients diagnosed with solid organ tumor between 2014 and 2023 who had no history of metabolic disease, at the diagnosis and on the 3rd, 6th, 9th or 12th months of treatment who had at least two abdominal scans taken during their routine check-up in Karadeniz Technical University, Department of Pediatrics, Department of Pediatric Hematology and Oncology. Thirty seven patients who had diagnosed between 2014 and 2021, retrospectively; twenty eight patients diagnosed between 2022 and 2023 were evaluated, prospectively. MRI scans were used to evaluate sarcopenia. Muscle strength and the physical performance of the patients who were 4 years of age or older at the time of diagnosis were evaluated as prospectively. The muscle strength of the patients was measured using a hand dynomometer. Time up and go test was used to evaluate physical performance in the patients. Results: In our study, 7.7% of the patients were severely sarcopenic, 53.8% were sarcopenic, 3.1% were probable sarcopenic, 35.4% were non-sarcopenic. The rate of sarcopenia in patients with solid organ tumors was 64.6%. A low positive correlation was found between muscle mass index and body weight, body weight persentile and height (respectively r:0,312 p<0,001, r:0,168 p:0,014, r:0,25 p<0,001). A moderate positive correlation was detected with body mass index (r:0,477 p<0,001). Hypoalbuminemia was present in 32 (74.4%) of patient with sarcopenia and in 11 (25.6%) of patients without sarcopenia (p:0,042). At the same time, the average hypoalbuminemia number of sarcopenic patients during treatment was 6.6 while the average of non-sarcopenic patients was 1.7 (p<0,001). It was determined that sarcopenia significantly increased the number of neutropenia, the neutropenic fever, the number of transfusions and the number of non-chemotherapy hospitalizations. Mortality occurred in 40% of patients with severe sarcopenia and in 2.9% of those with sarcopenia. Conclusions: The incidence of sarcopenia was high in pediatric patients followed by solid organ tumors and patients were seriously affected by sarcopenia. Sarcopenia was a cause of serious morbidity and mortality in childhood cancers. It is necessary to consider sarcopenia in childhood cancers to diagnose sarcopenia and prevent precautions to sarcopenia from developing. More studies are needed to evaluate about the sarcopenia in childhood cancers. More research is needed on the relationship between muscle mass index and body mass index. Keywords: Sarcopenia, Solid organ tumor, Physical performance, Muscle strenght, Muscle mass index, Body mass index, Hypoalbuminemia