欧洲老年人肌少症工作组 (EWGSOP) 推荐 SARC-F 作为识别老年人肌少症的工具。然而，SARC-F 在患有癌症的老年人中的作用仍有待探索。我们的目的是评估 SARC-F 的诊断效用，以通过计算机断层扫描 (CT) 成像和SARC-F 与全因死亡率的关联。在 UAB 肿瘤内科诊所进行初次咨询并接受老年评估的老年人（≥60 岁）被纳入一项前瞻性队列研究。我们确定了在研究入组后 60 天内完成 SARC-F 筛查并进行 CT 成像的研究参与者。使用 L3 椎体水平的单层 CT 图像，我们使用已发布的方法计算了 SMI 和 SMD。肌肉减少症和肌脂肪变性是使用已发表的切点来定义的。我们使用已发布的阈值计算了 SARC-F 检测低肌肉质量和低肌肉密度的敏感性和特异性。最后，在调整年龄、性别、癌症类型和癌症分期后，我们使用 Kaplan-Meier 曲线和 Cox 回归模型计算了 SARC-F 和 CT 测量对总体生存率的影响。我们确定了 212 名中位年龄为68.8岁；其中 60.8% 为男性，76.6% 为白人，胰腺癌 (21.2%) 是最常见的恶性肿瘤。在整个队列中，使用已发布的切点，30.7% 的人患有异常 SARC-F。 SARC-F ≥ 4 识别低肌肉质量的敏感性为 35%，特异性为 76%。 SARC-F ≥ 4 识别低肌肉密度的敏感性为 38%，特异性为 74%。与仅具有低 SMI/SMD 的患者相比，具有 SARC-F ≥ 4 和低 SMI/SMD 的患者的生存率更差。纳入 SARC-F 可以改善 SMI 和 SMD 之外的生存预后（HR = 3.1；p < 0.001；Harrel's C 从 0.73 到 0.76）。SARC-F 作为筛查工具，对于识别肌肉质量低和/或低的老年人的诊断效用有限。密度。然而，SARC-F 在预测老年癌症患者死亡率方面保留了独立于基于 CT 的肌肉测量的预后价值。© 2023 作者。约翰·威利出版的癌症医学

The European Working Group on Sarcopenia in Older People (EWGSOP) recommends SARC-F as a tool for identifying sarcopenia among older adults. However, the role of SARC-F among older adults with cancer remains unexplored. We aimed to evaluate the diagnostic utility of SARC-F to identify those with sarcopenia, or low muscle mass (using skeletal muscle index [SMI]), and myosteatosis (using skeletal muscle density [SMD]) from computed tomography (CT) imaging and the association of SARC-F with all-cause mortality.Older adults (≥60 years) presenting for initial consultation at UAB medical oncology clinic who underwent geriatric assessment were enrolled in a prospective cohort study. We identified study participants who completed SARC-F screening and had available CT imaging within 60 days of study enrollment. Using single-slice CT images at the L3 vertebral level, we computed SMI and SMD using published methods. Sarcopenia and myosteatosis were defined using published cutpoints. We calculated the sensitivity and specificity of SARC-F for detecting low muscle mass and low muscle density using published thresholds. Finally, we computed the impact of SARC-F and CT measures on overall survival using Kaplan-Meier curves and Cox regression models, after adjusting for age, sex, cancer type, and cancer stage.We identified 212 older adults with a median age of 68.8 years; with 60.8% males, 76.6% whites, and pancreatic cancer (21.2%) being the most common malignancy. In the overall cohort, 30.7% had abnormal SARC-F using published cutpoints. SARC-F ≥ 4 had a sensitivity of 35% and a specificity of 76% to identify low muscle mass. SARC-F ≥ 4 had a sensitivity of 38% and a specificity of 74% to identify low muscle density. Those with SARC-F ≥ 4 and low SMI/SMD had worse survival compared to those with low SMI/SMD alone. Incorporating SARC-F improved survival prognostication beyond SMI and SMD (HR = 3.1; p < 0.001; Harrel's C from 0.73 to 0.76).SARC-F as a screening tool has limited diagnostic utility for identifying older adults with low muscle mass and/or density. However, SARC-F retains prognostic value independent of CT-based muscle measures in predicting mortality among older adults with cancer.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.