Health-related quality of life in young pediatric cancer survivors: The role of sarcopenia

Sarcopenia is a prevalent musculoskeletal complication after pediatric cancer, and its association with health-related quality of life (HRQoL) remains unknown. This study aimed to investigate health-related quality of life (HRQoL) differences according to sarcopenia status in young pediatric cancer survivors, and determined if these differences were distinct by sex. This cross-sectional study included 116 pediatric cancer survivors (12.1 ± 3.3 years old). Muscle strength was evaluated by handgrip strength test, while appendicular lean mass index (ALMI, kg/m2) was estimated via dual‑energy X‑ray absorptiometry. “Sarcopenia probable” was defined when muscle strength was ≤ decile 2 and ALMI Z-score was > -1.5 standard deviation (SD). “Sarcopenia confirmed” was defined when muscle strength was ≤ decile 2 and ALMI Z-score ≤ -1.5 SD. HRQoL was assessed using the Spanish version of the PedsQL 4.0 Generic Core Scales, and compared with age-specific reference values of healthy young population to calculate Z-scores. Only female survivors without sarcopenia had significantly better total HRQoL (-0.3 [95% CI: -0.8 to 0.2] vs. 1.5 [95% CI: -2.1 to -0.8]), physical HRQoL (-0.3 [95% CI: -0.8 to 0.2] vs. -1.6 [95% CI: -2.3 to -0.9]), psychosocial HRQoL (-0.2 [95% CI: -0.7 to 0.3] vs. -1.2 [95% CI: -1.8 to -0.6]) and school HRQoL (-0.1 [95% CI: -0.6 to 0.4] vs. -1.3 [95% CI: -2.0 to -0.7]) than female survivors with sarcopenia confirmed. Most HRQoL domains are similar across sarcopenia status in young pediatric cancer survivors. However, female survivors without sarcopenia seem to have better HRQoL Z-score than those with sarcopenia.