Muscle mass, not radiodensity, predicts physical function in cancer patients with or without cachexia.

BACKGROUND: There is a need to better understand the relationship between functional impairment and muscle mass in cancer cachexia. This study aimed to establish the relationship between computed tomography (CT)-derived muscle cross-sectional area (CSA), radiodensity, and skeletal muscle index (SMI) and dual energy X-ray absorptiometry (DXA) parameters with functional performance in cancer patients.

MATERIALS AND METHODS: Handgrip strength, stair climb power (SCP), one-repetition maximum (1RM) strength, and body composition (CT and DXA) were compared across cancer patients with cachexia (CAC; = 28), without cachexia (CNC; = 28), and non-cancer patients (CON; = 19). Multivariate regression was performed to find predictors of function.

RESULTS: CAC had lower CT muscle CSA and SMI and lower DXA appendicular lean mass (ALM) than CNC or CON ( ≤ 0.011). Muscle radiodensity was not different across groups despite larger proportion of low CT SMI in CAC, and CAC performed worse in SCP than CON ( = 0.018). In cancer patients, DXA ALM and CT muscle CSA each predicted physical function ( ≤ 0.05); muscle radiodensity did not, and DXA ALM explained more variability in SCP and 1RM than CT muscle CSA.

CONCLUSIONS: Stair climb power was reduced in cancer cachexia; muscle radiodensity was not. Muscle mass by CT or DXA, but not radiodensity, predicted functional performance in cancer patients.