Two-arm study of sarcopenia in geriatric patients with high-grade glial tumors: temporal muscle thickness and prognostic nutritional index.

Purpose: To analyze the prognostic significance of temporal muscle thickness (TMT) and prognostic nutritional index (PNI) in the assessment of sarcopenia in patients diagnosed with glioblastoma multiforme (GBM) in the geriatric age group.

Methods: This study included a total of 50 patients (≥65 years of age) receiving radiotherapy (RT)/radio-chemotherapy (RCT) at Kayseri City Education and Research Hospital. We calculated TMT from cranial magnetic resonance imaging (MRI) at the time of diagnosis and PNI from laboratory measurements. To determine the cut-off values, we used the ROC analysis. The combined group (CG) was formed according to TMT and PNI.

Results: Median overall survival (OS) was 5 months. OS for those with TMT < 6.75 cm and ≥ 6.75 cm was 5 months and 11 months, respectively (p < 0.001). OS for those with PNI < 48.87 cm and ≥ 48.87 cm was 5 months and 11 months, respectively (p = 0.026). Survival analysis showed a dramatic difference in CG between groups 1 and 4 (16 months vs. 4 months, p < 0.001). Correlations were observed between TMT and age, excision type and OS (r = 0.406 p = 0.003, r = 0.346 p = 0.014, r = 0.345 p = 0.014). Univariate Cox regression analysis showed that age, excision type, diagnosis type, RT history, initial tumor volume (ITV), TMT, PNI, CG, and albumin had an effect on survival (p values 0.017, <0.001, <0.001, <0.001, 0.011, <0.001, 0.041, 0.001, and 0.018, respectively). Multivariate Cox regression analysis showed that excision type, RT history, ITV, albumin, and CG were independent factors affecting survival (p values 0.007, 0.05, 0.005, 0.029, and 0.014, respectively).

Conclusion: Although both parameters individually have a prognostic effect in geriatric GBM patients, their combined effect as a single parameter has a much stronger impact on prognosis.