Vol. 14. Núm. 25.
Páginas 1516-1520 (Febrero 2025)

Protocolos de práctica asistencial
Protocolo diagnóstico y terapéutico de la sarcopenia en los tumores gastrointestinales

Diagnostic and treatment protocol for sarcopenia in gastrointestinal tumors

M. Cruz GómezaA. Villalba YllánbM.J. Rodríguez TroyanocR. Molina Villaverded
Doi : https://10.1016/j.med.2025.01.018
Opciones
Resumen

La sarcopenia es una enfermedad muscular relacionada con la edad caracterizada por una disminución de la masa, la fuerza y la funcionalidad del músculo esquelético. La prevalencia es muy alta en pacientes con tumores gastrointestinales por la afectación directa de la deglución y la digestión. A pesar de la falta de consenso, se recomienda realizar un cribado del riesgo nutricional en el momento del diagnóstico tumoral y elaborar un plan terapéutico individualizado. El diagnóstico de sarcopenia se realizará teniendo en cuenta la baja fuerza y la masa muscular según los criterios propuestos por el grupo europeo sobre sarcopenia (EWGSOP/EWGSOP2). El tratamiento temprano multifactorial basado en una terapia nutricional y farmacológica, junto con el ejercicio físico, ha demostrado disminuir la incidencia de la sarcopenia a lo largo de la enfermedad. La sarcopenia es un factor pronóstico independiente de la enfermedad tumoral, debido a que disminuye la eficacia de los tratamientos oncológicos, aumentando la tasa de recurrencia tumoral y, en términos generales, supone una disminución de la supervivencia.

Palabras clave
Cáncer
Sarcopenia
Tumor gastrointestinal
Abstract

Sarcopenia is an age-related muscle disease characterized by a decrease in skeletal muscle mass, strength, and functionality. The prevalence is very high in patients with gastrointestinal tumors due to the direct involvement of swallowing and digestion. Despite a lack of consensus, it is recommended to screen for nutritional risk at the time the tumor is diagnosed and to develop an individualized treatment plan. The diagnosis of sarcopenia will be made taking into account the low strength and muscle mass according to the criteria proposed by the European Working Group on Sarcopenia in Older People (EWGSOP/EWGSOP2). Early multifactorial treatment based on nutritional and pharmacological therapy together with physical exercise has been shown to decrease the incidence of sarcopenia throughout the course of the disease. Sarcopenia is an independent prognostic factor of tumor disease because it decreases the efficacy of oncological treatments, which increases the rate of tumor recurrence and, in general terms, entails a decrease in survival.

Keywords
Cancer
Sarcopenia
Gastrointestinal tumor

Identifíquese

¿Aún no es suscriptor de la revista?

Comprar el acceso al artículo

Comprando el artículo el pdf del mismo podrá ser descargado

Teléfono para incidencias

De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h

Llamadas desde España 932 415 960
Llamadas desde fuera de España +34 932 415 960
Bibliografía
[1]
D. Meza-Valderrama
202502100823208808
202502100823208809
, E. Marco, V. Dávalos-Yerovi, M.D. Muns, M. Tejero-Sánchez, E. Duarte, et al.
Sarcopenia, malnutrition, and cachexia: Adapting definitions and terminology of nutritional disorders in older people with cancer.
Nutrients., (2021), 13 pp. 761
[2]
L. Xia
2025021008232088010
, R. Zhao, Q. Wan, Y. Wu, Y. Zhou, Y. Wang, et al.
Sarcopenia and adverse health-related outcomes: An umbrella review of meta-analyses of observational studies.
Cancer Med., (2020), 9 pp. 7964-7978
[3]
P. Bossi
2025021008232088011
, P. Delrio, A. Mascheroni, M. Zanetti.
The spectrum of malnutrition/cachexia/sarcopenia in oncology according to different cancer types and settings: A narrative review.
Nutrients., (2021), 13 pp. 1980
[4]
S. Peixoto da Silva
2025021008232088012
, J.M.O. Santos, M.P. Costa e Silva, R.M. Gil da Costa, R. Medeiros.
Cancer cachexia and its pathophysiology: links with sarcopenia, anorexia and asthenia.
J Cachexia Sarcopenia Muscle., (2020), 11 pp. 619-635
[5]
F.M. Zhang
2025021008232088013
2025021008232088014
, H.F. Wu, H.P. Shi, Z. Yu, C.L. Zhuang.
Sarcopenia and malignancies: epidemiology, clinical classification and implications.
Ageing Res Rev. e, (2023), 91 pp. 102057
[6]
C. Compher
2025021008232088015
2025021008232088016
, T. Cederholm, M.I.T.D. Correia, M.C. González, T. Higashiguch, H.P. Shi, et al.
Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition.
J Parenter Enter Nutr., (2022), 46 pp. 1232-1242
[7]
M.P. Davis
2025021008232088017
, R. Panikkar.
Sarcopenia associated with chemotherapy and targeted agents for cancer therapy.
Ann Palliat Med., (2019), 8 pp. 8601-9101
[8]
F. Bozzetti
2025021008232088018
.
Nutritional interventions in elderly gastrointestinal cancer patients: the evidence from randomized controlled trials.
Support Care Cancer., (2019), 27 pp. 721-727
[9]
A.R. Mislang
2025021008232088019
2025021008232088020
, S. Di Donato, J. Hubbard, L. Krishna, G. Mottino, F. Bozzetti, et al.
Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper.
J Geriatr Oncol., (2018), 9 pp. 382-392
[10]
T. Ispoglou
2025021008232088021
2025021008232088022
, D. McCullough, A. Windle, S. Nair, N. Cox, H. White, et al.
Addressing cancer anorexia-cachexia in older patients: Potential therapeutic strategies and molecular pathways.
Clin Nutr Edinb Scotl., (2024), 43 pp. 552-566
[11]
K. Yamashita
2025021008232088023
, Y. Miyazaki, D. Nakatani, Y. Masuike, K. Tanaka, K. Sugimura, et al.
OSK-0028 in Patients With Esophageal Cancer Undergoing Esophagectomy: A Double-blind, Randomised Controlled Trial.
Anticancer Res., (2021), 41 pp. 3875-3884