LB103 - MUSCLE QUALITY AND FUNCTION ASSESSED BY CT, ULTRASOUND, AND BIVA IN PATIENTS WITH ESOPHAGOGASTRIC CANCER

LB103

MUSCLE QUALITY AND FUNCTION ASSESSED BY CT, ULTRASOUND, AND BIVA IN PATIENTS WITH ESOPHAGOGASTRIC CANCER

E. Vieira Maroun^1,*, M. Argente Pla², J. F. Merino Torres²

¹Instituto de Investigación Sanitaria La Fe, ²Servicio de Endocrinología y Nutrición, Hospital Universitario y Politécnico La Fe, Valencia, Spain

Rationale: Muscle dysfunction and poor quality are key predictors of adverse outcomes in patients with esophagogastric cancer. While sarcopenia definitions emphasize reduced muscle mass and strength, skeletal muscle density (SMD)—an indicator of myosteatosis—may deteriorate earlier, reflecting muscle quality loss due to adipose infiltration. This study aimed to assess the association between muscle strength, quantity, and quality with functional performance.

Methods: Cross-sectional study of 53 patients with esophagogastric cancer. Physical performance was evaluated with the Short Physical Performance Battery (SPPB), and handgrip strength (HGS) measured with a Jamar dynamometer. Dynapenia and sarcopenia were defined according to EWGSOP2 criteria. Body composition was assessed by CT at L3 using FocusedON-BC®, rectus femoris (RF) ultrasound (U-PROBE L6C®), and BIVA (NUTRILAB®). Myosteatosis was defined as low SMD or <41 (BMI<25) or <33 (BMI≥25) Hounsfield units (HU). Statistical analysis included t-test and univariable logistic regression adjusted for age, sex, and tumor location.

Results: Mean age was 63.5±9.4 years; 77.4% male; 66% had esophageal and 34% gastric cancer. Dynapenia was present in 28.8%, and sarcopenia in 26.9%. Low physical performance (SPPB≤8) was seen in 37.7%. Patients with dynapenia had significantly lower radiodensity (HU) in muscle (p=0.045), and in lean muscle (p=0.028). However, skeletal muscle index (SMI) measured by CT (p=0.408) and appendicular skeletal muscle mass index (ASMMI) by BIVA (p=0.051) did not differ significantly. Radiodensity of lean muscle was significantly associated with dinapenia (OR=0.923, 95%CI 0.860–0.990, p=0.024; AUC=0.695). Low SPPB was also associated with HGS (p=0.017), ASMMI (p=0.005), and RF thickness in contraction (p=0.02). Prevalence of myosteatosis was 52.8%, nearly double that of sarcopenia(26.9%), and 52.6% of patients had isolated low SMD without sarcopenia. 

Conclusion: In esophagogastric cancer patients, muscle quality (SMD) and function (RF contraction) appear to be better indicators of dynapenia and physical impairment than muscle mass alone. Notably, myosteatosis was more prevalent than sarcopenia, supporting the notion that muscle quality deteriorates earlier and should be prioritized in clinical assessment.

Disclosure of Interest: None declared