Sarcopenia with decreased total psoas muscle area in children with high-risk neuroblastoma

Background: We calculated psoas muscle area (PMA) z -scores in high -risk neuroblastoma patients undergoing treatment to examine the clinical signi ficance of sarcopenia in this cohort. Methods: We analyzed retrospective data from patients aged 0-18 who were diagnosed with abdominal neuroblastoma between 2005 and 2019 at Samsung Medical Center. Patients categorized as high -risk undergone induction chemotherapy, neuroblastoma excision, and tandem high -dose chemotherapy with autologous stem cell transplantation (HDCT/auto-SCT) were selected. L3-4 lumbar levels on axial CT images were identi fied and we measured the areas of the left and right psoas muscles to determine tPMA. Total PMA z -scores were calculated using an open online tool. Results: There were 45 boys and 25 girls with a mean age of 3.86 years. CT images taken at initial diagnosis and after tandem HDCT/auto-SCT were selected to calculate tPMA z -scores. Mean elapsed time between the two measurements was 12.91 +/- 1.73 months. Mean tPMA z -score signi ficantly decreased from -0.21 +/- 1.29 to -0.66 +/- 0.97 (p = 0.022). Length of hospital stay was signi ficantly longer in the group of patients whose tPMA z -scores decreased by more than .45 (177.62 +/- 28.82 days vs. 165.75 +/- 21.34 days, p = 0.049). Presence of sarcopenia at initial diagnosis was a signi ficant risk factor for bacterial infection during neuroblastoma treatment. Conclusion: tPMA z -scores in high -risk neuroblastoma patients decreased signi ficantly following a treatment regimen that included induction chemotherapy, tumor resection surgery, and HDCT/auto-SCT. A greater decrease in tPMA z -score was associated with longer hospital stay during treatment. (c) 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).