Retrospective Evaluation of Sarcopenia and Its Effect on Clinical Follow-Up in Pediatric Patients With Solid Organ Tumors

Objective: This study aimed to retrospectively identify sarcopenia in pediatric patients with solid organ tumors; additionally, it was designed to evaluate the impact of sarcopenia on the clinical follow-up, treatment, and prognosis of these patients, and to enhance awareness of sarcopenia based on the data obtained. Materials and Methods: Sarcopenia screening was conducted in 65 patients diagnosed with solid organ tumors who met the following criteria: 1) no history of any metabolic disease, and 2) at least two abdominal MRI scans taken during routine follow-up visits at diagnosis, and at 3, 6, 9, or 12 months of treatment. Thirty-seven patients were evaluated retrospectively, and 28 patients were evaluated prospectively. To assess sarcopenia, MRI scans in the system were used; muscle strength was evaluated using a hand dynamometer, and physical performance was assessed using the Timed Up and Go (TUG) test in patients aged 4 and older at diagnosis and included in the prospective study. Results: In our study, 7.7% of patients had severe sarcopenia, 53.8% had sarcopenia, 3.1% had probable sarcopenia, and 35.4% did not have sarcopenia. The incidence of sarcopenia in patients with solid organ tumors in our center was 64.6%. A low-degree positive correlation was found between muscle mass index and body weight, body weight percentile, and height; a moderate-degree positive correlation was found with body mass index (r: 0.312, p<0.001; r: 0.168, p: 0.014; r: 0.25, p<0.001; r: 0.477, p<0.001, respectively). Hypoalbuminemia was present in 32 (74.4%) of sarcopenic patients and 11 (25.6%) of non-sarcopenic patients (p: 0.042). Concurrently, the average number of hypoalbuminemia episodes during treatment was 6.6 in sarcopenic patients, while it was 1.7 in non-sarcopenic patients (p<0.001). Our study found that sarcopenia significantly increased the neutropenia count, the number of febrile neutropenia episodes, the number of transfusions, and the number of non-chemotherapy hospitalizations (p: 0.019, p: 0.008, p: 0.002, p: 0.002, respectively). Mortality was observed in 40% of patients with severe sarcopenia and 2.9% of patients with sarcopenia. Conclusion: The incidence of sarcopenia is high in pediatric patients followed up for solid organ tumors, and these patients are significantly affected by sarcopenia. In pediatric cancers, it is necessary to consider sarcopenia, to diagnose it, and to take the necessary precautions to prevent it.