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Gastric Cancer
Published in: Gastric Cancer 1/2019

01-01-2019 | Review Article

Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis

Authors: Sivesh K. Kamarajah, James Bundred, Benjamin H. L. Tan

Published in: Gastric Cancer | Issue 1/2019

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Abstract

Introduction

There has recently been increased interest in the assessment of body composition in patients with gastric cancer for the purpose of prognostication. This systematic review and meta-analysis aim to evaluate the current literature on body composition assessment in patients with gastric cancer and its impact on peri-operative outcomes.

Methods

A systematic literature search was conducted for studies reporting assessment of body composition in patients with gastric cancers. Meta-analysis of postoperative outcomes (overall and major complications, anastomotic leaks, pulmonary complications) and survival was performed using random effects models.

Results

Thirty-nine studies reported the assessment of body composition in 8402 patients. Methods used to assess body composition in patients with gastric cancers were computerized tomography (n = 26), bioelectrical impedance analysis (n = 9), and dual-energy-X-ray-absorptiometry (n = 3). Only 21 studies reported the impact of pre-operative sarcopenia on post-operative outcomes. Sarcopenic patients have significantly higher rates of postoperative major complications (n = 12, OR 1.67, CI95% 1.14–2.46, p = 0.009), and pulmonary (n = 8, OR 4.01, CI95% 2.23–7.21, p < 0.001) complications after gastrectomy. Meta-analysis of nine studies reporting overall survival after gastrectomy identified significantly worse survival in patients with pre-operative sarcopenia (HR 2.12, CI95% 1.89–2.38, p < 0.001).

Conclusions

Assessment of body composition has the potential to become a clinically useful tool that could support decision-making in patients with gastric cancer. However, variation in methods of assessing and reporting body composition in this patient group limits assessment of current post-operative outcomes
Appendix
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Metadata
Title
Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis
Authors
Sivesh K. Kamarajah
James Bundred
Benjamin H. L. Tan
Publication date
01-01-2019
Publisher
Springer Singapore
Published in
Gastric Cancer / Issue 1/2019
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-018-0882-2

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