Muscle mass (quantity) and radiodensity (quality) are associated with symptom burden, clinical outcomes, and survival among patients with advanced cancer. These findings, from a prospective study, were published in the Journal of the National Comprehensive Cancer Network.

Loss of skeletal muscle is common among hospitalized patients with advanced cancer. Although the importance of muscle mass has been studied, the effects of muscle radiodensity or attenuation is not well-understood. Therefore, researchers sought to analyze the relationship between overall muscle health (quality and quantity), physical and psychological symptoms, healthcare use (hospital length of stay and readmissions) and survival.

For this study, 677 patients with advanced cancer who made an unplanned visit to Massachusetts General Hospital between 2014 and 2016 were enrolled in this study. Patients completed a symptom burden questionnaire and body composition was assessed by computed tomography scan.

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Mean age of participants was 62.86±12.95 years, 51.1% were women, 92.2% were White, and BMI was 25.90±6.03 kg/m2. The most common cancers were gastrointestinal (36.8%), lung (16.7%), and genitourinary (8.9%).

Mean muscle mass was 43.61±8.69 cm2/m2. Muscle mass was reduced among women (P <.001) and older patients (P <.001), but increased among patients with higher BMI (P <.001).

Average muscle radiodensity was 33.31±10.61 Hounsfield units (HU). This was reduced among women (P =.014), patients who were older (P <.001), those with breast cancer (P =.028), and those with higher BMI (P <.001); it was increased among patients with higher educational attainment (P =.003).

A relationship was observed between muscle mass and risk of death (hazard ratio [HR], 0.969; 95% CI, 0.955-0.982; P <.001); and between muscle radiodensity and risk of death (HR, 0.969; 95% CI, 0.958-0.981; P <.001), readmission or death at 90 days (odds ratio [OR], 0.966; 95% CI, 0.945-0.986; P <.001), and hospital stay (95% CI, –0.117 to –0.021; P =.005).

This study was limited by its lack of diversity.

These data indicated poor muscle health in patients with advanced cancer were associated with increased healthcare burden and mortality.

Disclosure: Multiple authors declared affiliations with or received funds from industry. Please refer to the original article for a full list of disclosures.


van Seventer E, Marquardt JP, Troschel AS, et al. Associations of skeletal muscle with symptom burden and clinical outcomes in hospitalized patients with advanced cancer. J Natl Compr Canc Netw. 2021;19(3):319-327. doi:10.6004/jnccn.2020.7618