Purpose: This study investigated the association between frailty and history of cancer in older orthopedic outpatients.
Methods: This study included 1,339 older orthopedic rehabilitation outpatients (aged ≥ 65 years) admitted to our hospital. The Kihon Checklist was used to assess the presence of frailty at the start of rehabilitation. Binary logistic regression analysis was performed using the presence or absence of a history of cancer as an independent variable, and frailty, multiple troubles, physical function, nutritional status, oral function, houseboundness, cognitive function, and depressive mood as dependent variables.
Results: A history of cancer was significantly associated with frailty, nutritional status, houseboundness, and depressed mood on the Kihon Checklist. The most among them, houseboundness was particularly associated with having a history of cancer.
Conclusion: The evaluation and treatment of houseboundness are important in older orthopedic outpatients with a history of cancer.

Purpose: This study investigated the influence of the coronavirus disease 2019 (COVID-19) pandemic on the prevalence of frailty in older orthopedic outpatients with a history of cancer.
Methods: This study included 966 older orthopedic rehabilitation outpatients (aged ≥ 65 years) admitted to our hospital. The Kihon Checklist was used to assess the presence of frailty at the start of rehabilitation. Binary logistic regression analysis was performed using the presence or absence of a history of cancer as an independent variable, and frailty, multiple troubles, physical function, nutritional status, oral function, outdoor activity, cognitive function, and depressive mood as dependent variables before and after the COVID-19 pandemic.
Results: Based on the Kihon Checklist, having a history of cancer was significantly associated with frailty and physical function in late older orthopedic outpatients after the COVID-19 pandemic.
Conclusion: The evaluation and treatment of frailty and physical function are important in late older orthopedic outpatients with a history of cancer after the COVID-19 pandemic.

Objects: The single-center retrospective cohort study aimed to detect the optimal cutoff point of skeletal muscle mass loss after esophagectomy in Japanese patients with esophageal cancer.
Methods: Subjects were patients with esophageal cancer who had undergone curative esophagectomy at National Cancer Center Hospital East in Japan between 2016 and 2020. Skeletal muscle mass index (SMI) loss was calculated with computer tomography images at preoperatively and four months after surgery. The optimal cutoff point of SMI loss was detected using the Log-rank test.
Results: A total of 384 patients were analyzed. The average SMI loss was 4.6%. The optimal cutoff point of SMI loss was detected as 10% (Chi-square value: 19.8, p < 0.001). A larger SMI loss than 10% had a significant impact on 3-year overall survival, resulting from the Cox proportional hazard model [Adjusted hazard ratio: 3.864 (95% confidence interval: 2.054–7.267), p < 0.001].
Conclusion: This present study showed that the optimal cutoff point of skeletal muscle mass loss after esophagectomy was 10% using survival as an anchor.

Introduction: In this study, we investigated the association between serum biomarkers and skeletal muscle function in patients with advanced or recurrent lung or pancreatic cancer.
Methods: This single-center retrospective cohort study included patients with lung or pancreatic cancer before the administration of chemotherapy. In addition to basic information, we recorded serum biomarker levels (interleukin [IL]-6, tumor necrosis factor [TNF]-α, and insulin-like growth factor [IGF]-1) and skeletal muscle function indicators (skeletal muscle mass index [SMI], lean body mass [LBM], and grip strength). A linear regression analysis was performed after a univariate regression analysis with skeletal muscle function as the dependent variable and serum biomarkers as independent variables.
Results: The study included 17 patients. The univariate regression analysis revealed a significant association between TNF-α and grip strength (p = 0.0134), IGF-1 and SMI (p = 0.0175), and IGF-1 and LBM (p = 0.0152). This significant association between TNF-α and grip strength persisted despite the adjustment for confounders. Notably, the significant association between IGF-1 and SMI as well as between IGF-1 and LBM persisted despite the adjustment for confounders other than age. In contrast, serum IL-6 level was not significantly associated with skeletal muscle function.
Conclusion: Serum TNF-α and IGF-1 levels were associated with skeletal muscle function in patients with advanced or recurrent lung or pancreatic cancer.

Objective: To evaluate the associations between preoperative possible sarcopenia (PS) related postoperative complications and prolonged duration of hospitalization in patients with gastric or colorectal cancer by measuring handgrip strength decline and five-time sit-to-stand test delay.
Methods: Seventy-five patients who were admitted to an acute hospital and discharged after surgery were included in this study. We determined preoperative PS, hand grip strength decline, and five-time sit-to-stand test delay according to the Asian Working Group for Sarcopenia 2019 to establish the association between the occurrence of postoperative complications and length of hospital stay.
Results: Although PS was significantly associated with the occurrence of postoperative complications and prolonged duration of hospitalization postoperatively. Hand grip strength decline and five-time sit-to-stand test delay were not significantly associated with the occurrence of postoperative complications and prolonged duration of hospitalization.
Conclusion: Our findings show that preoperative PS is associated with the occurrence of postoperative complications and prolonged duration of hospitalization in patients with gastric and colorectal cancer.

Introduction: We present our experiences with four patients with advanced or recurrent solid cancers, who underwent neurological evaluations through an outpatient rehabilitation system.
Methods: Neurological evaluations were performed, and the emergence of new symptoms during rehabilitation interventions for metastatic brain tumors, which had been revealed on head magnetic resonance imaging, were examined.
Results: In two patients with new symptoms, the causes were a metastatic brain tumor and peripheral neuropathy, respectively. One patient, with a metastatic brain tumor, experienced no new symptoms.
Conclusion: Although the presence or absence of neurological symptoms does not necessarily correspond to the presence or absence of a metastatic brain tumor, evaluations of neurological findings are useful for rehabilitation professionals when treating patients with advanced or recurrent solid tumors receiving outpatient chemotherapy. In the future, considering the frequency of neurological evaluations and content of the assessment battery used are necessary.

Objective: We report an experience with low intensity exercise therapy for a lung cancer patient undergoing chemotherapy with undernutrition and low physical activity.
Case: A woman in her 80s with an Eastern Cooperative Oncology Group Performance Status of 2 diagnosed with postoperative recurrence of lung cancer. The patient was at risk for early discontinuation of chemotherapy because her anorexia did not improve during chemotherapy and was accompanied by low physical activity. Physical therapy was performed with exercise therapy on the rating of perceived exertion (Borg Scale) 11 to maintain physical function and skeletal muscle mass.
Results: The patient received 9 courses of chemotherapy and had a partial response. During the treatment period the cross-sectional area of the body fat of the third lumbar vertebra decreased significantly, while the cross-sectional area of the skeletal muscle of third lumbar vertebra, knee extension muscle strength, Short Physical Performance Battery, and gait speed did not decrease.
Conclusion: This case suggests that low-intensity exercise therapy may prevent loss of physical function and skeletal muscle mass and contribute to chemotherapy continuity for low physical activity lung cancer patients who have difficulty improving their low undernutritional status.