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Cancer Imaging

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Open Access 01-12-2019 | Sarcopenia | Review

CT-assessed sarcopenia is a predictive factor for both long-term and short-term outcomes in gastrointestinal oncology patients: a systematic review and meta-analysis

Authors: Huaiying Su, Junxian Ruan, Tianfeng Chen, Enyi Lin, Lijing Shi

Published in: Cancer Imaging | Issue 1/2019

Abstract

Background

The impact of sarcopenia on the outcome of gastrointestinal (GI) oncological patients is still controversial. We aim to discuss the prevalence of sarcopenia and its relation to the oncological outcome.

Methods

Embase, Medline, PubMed, and the Cochrane library were systematically searched for related keywords. Studies using CT to assess sarcopenia and evaluate its relationship with the outcome of GI oncological patients were included. Long-term outcomes, including overall survival and disease-free survival, were compared by hazard ratios (HRs) with 95% confidence intervals (CIs). Short-term outcomes, including total complications and major complications (Clavien-Dindo ≥IIIa) after curable surgery, were compared by the risk ratio (RR) and 95% CI.

Results

A total of 70 studies including 21,875 patients were included in our study. The median incidence of sarcopenia was 34.7% (range from 2.1 to 83.3%). A total of 88.4% of studies used skeletal muscle index (SMI) in the third lumbar level on CT to define sarcopenia, and a total of 19 cut-offs were used to define sarcopenia. An increasing trend was found in the prevalence of sarcopenia when the cut-off of SMI increased (β = 0.22, 95% CI = 0.12–0.33, p < 0.001). The preoperative incidence of sarcopenia was associated both with an increased risk of overall mortality (HR = 1.602, 95% CI = 1.369–1.873, P < 0.001) and with disease-free mortality (HR = 1.461, 95% CI = 1.297–1.646, P < 0.001). Moreover, preoperative sarcopenia was a risk factor for both total complications (RR = 1.188, 95% CI = 1.083–1.303, P < 0.001) and major complications (RR = 1.228, 95% CI = 1.042–1.448, P = 0.014).

Conclusion

The prevalence of sarcopenia depends mostly on the diagnostic cut-off points of different criteria. Preoperative sarcopenia is a risk factor for both long-term and short-term outcomes.

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Title: CT-assessed sarcopenia is a predictive factor for both long-term and short-term outcomes in gastrointestinal oncology patients: a systematic review and meta-analysis
Authors: Huaiying Su
Junxian Ruan
Tianfeng Chen
Enyi Lin
Lijing Shi
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Sarcopenia
Gastric Cancer
Gastric Cancer
Colorectal Cancer
Colorectal Cancer
Esophageal Cancer
Esophageal Cancer
Computed Tomography
Computed Tomography
Published in: Cancer Imaging / Issue 1/2019
Electronic ISSN: 1470-7330
DOI: https://doi.org/10.1186/s40644-019-0270-0

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Keynote webinar | Spotlight on antibody–drug conjugates in cancer

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At a glance: The STEP trials

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