Prognostic Role of Muscle Depletion in Palliative Care Patients With Incurable Cancer: A Retrospective Study

Abstract Background: Depletion of muscle mass and strength has been proven to be a negative prognostic indicator for patients with cancer receiving anticancer treatment. However, little is known about its role in palliative care patients. The objective of this study was to evaluate the prognostic significance of muscle depletion in predicting survival among patients in palliative care.Methods: We retrospectively examined the association between muscle mass and strength and prognosis in patients with incurable solid cancer who are supported by a palliative care team at a university hospital. Psoas muscle index (PMI) at the level of the fourth lumbar vertebra was employed as the muscle mass index. Pinch grip strength (PGS) was used as the muscle strength index. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival.Results: A total of 78 patients were included in this study (35 male, median age 67 years). Median survival was 87.5 (95% confidence interval [CI] 50–124) days. After adjustment for age, sex, albumin, edema, and performance status as potential confounders, loss of PMI (HR=0.998, 95% CI 0.996–0.999; P=0.003) and PGS (HR=0.73, 95% CI 0.55–0.97; P=0.030) independently predicted the overall survival.Conclusion: Depletion of muscle mass and strength is an independent predictor of survival in patients with incurable solid cancer receiving palliative care. PMI and PGS may help to better assess the prognosis of patients in palliative care.