Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Kawaguchi, Yo; Hanaoka, Jun; Ohshio, Yasuhiko; Okamoto, Keigo; Kaku, Ryosuke; Hayashi, Kazuki; Shiratori, Takuya; Akazawa, Akira

doi:10.21037/jtd-20-3072

Cited by 30 publications

(26 citation statements)

References 44 publications

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“…The research team of eight [ 18 , 20 – 25 , 27 ] reviews was based in Asian countries, five [ 16 , 17 , 26 , 28 , 29 ] in European countries, and one [ 19 ] in the United States of America. Eight [ 16 – 21 , 24 , 29 ] reviews focused on malignancies of pulmonary origin, with four [ 18 , 21 , 24 , 29 ] solely examining NSCLC and four [ 16 , 17 , 19 , 20 ] encompassing all lung cancers. The remaining six [ 22 , 23 , 25 – 28 ] reviews incorporated tumors from multiple locations and dedicated a portion to lung cancer.…”

Section: Resultsmentioning

confidence: 99%

“…According to the critical appraisal using AMSTAR2, one review [ 20 ] had high, nine had low [ 17 , 18 , 21 – 23 , 25 , 27 – 29 ], and four [ 16 , 17 , 19 , 24 , 26 ] had critically low evidence quality. Common methodological problems were lack of prior protocol registration (only registered in two reviews [ 27 , 29 ]), not employing a comprehensive search strategy (three reviews [ 19 , 24 , 26 ] used only PubMed for literature search and 12 [ 16 – 19 , 22 – 29 ] did not consider trial registries), and not providing sufficient information on the excluded studies (only recorded in three reviews [ 16 , 20 , 25 ]). Seven reviews [ 18 , 19 , 22 – 24 , 26 , 28 ] did not elaborate on duplicate study selection, and seven [ 16 , 17 , 22 , 23 , 26 – 28 ] did not show independent data extraction by two authors.…”

Section: Resultsmentioning

confidence: 99%

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Impact of sarcopenia on the prognosis and treatment of lung cancer: an umbrella review

Lin

Chen

et al. 2022

Discov Onc

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Background Lung cancer is the leading cause of cancer-related mortality worldwide. Sarcopenia, defined as the loss of muscle mass and function, is known to cause adverse health outcomes. The purpose of this umbrella review was to integrate published systematic reviews and meta-analyses exploring sarcopenia and lung cancer to provide comprehensive knowledge on their relationship. Methods Eligible studies were searched from scientific databases until June 28, 2022. Critical appraisal was performed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2. The impact of sarcopenia on the pathophysiology, prevalence, and prognosis of lung cancer is summarized at the level of systematic reviews or meta-analyses. Results Fourteen reviews and meta-analyses were conducted. The methodological quality was high for one review, low for nine, and critically low for four. The most common standard for diagnosing sarcopenia in the lung cancer population is computed tomography (CT) to measure the skeletal muscle index at the third lumbar vertebra (L3). Sarcopenia was highly prevalent among patients with lung cancer, with a pooled prevalence ranging from 42.8% to 45.0%. The association between sarcopenia and increased postoperative complications and decreased disease control rates with immune checkpoint inhibitors has been demonstrated. Mortality was significantly higher in sarcopenic patients than in non-sarcopenic patients with lung cancer, regardless of the stage of disease or type of treatment. Conclusions Sarcopenia is a poor prognostic factor for lung cancer. Future studies are necessary to clarify the pathophysiology of sarcopenia and develop effective interventions for sarcopenia in patients with lung cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Impact of sarcopenia on the prognosis and treatment of lung cancer: an umbrella review

Lin

Chen

et al. 2022

Discov Onc

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“…We could not determine whether sarcopenia directly affected cancer recurrence using OS or DFS, because decreases in OS or DFS are not only attributable to lung cancer death/recurrence, but also to deaths from other diseases. Indeed, sarcopenia itself is a poor prognostic factor, because the loss of muscle mass and strength results in physical disability and death [ 10 , 23 ]. Second, we focused on lobectomy as the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…First, sarcopenia itself is generally accepted to confer poor prognosis. Even if the cancer is completely cured through surgery, there is loss of skeletal muscle mass and strength, resulting in physical disability and death [ 10 ]. Second, sarcopenia may also contribute to the risk of cancer recurrence [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia increases the risk of post-operative recurrence in patients with non-small cell lung cancer

et al. 2021

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Background Sarcopenia is among the most prevalent and serious cancer-related symptom, and is strongly correlated with a poor prognosis. Moreover, it reportedly predicts poor prognosis after surgery in patients with lung cancer. However, it is unclear whether sarcopenia directly affects post-operative recurrence. The purpose of this study was to evaluate whether sarcopenia can be a risk indicator for post-operative recurrence, and whether it suppresses anti-tumor immunity, in a cohort of patients with resected non-small cell lung cancer. Methods This study retrospectively reviewed the data of 256 consecutive patients who underwent curative lobectomy and lymph node dissection for non-small cell lung cancer at our institution. The psoas muscle mass index was calculated as the total psoas muscle area at the third lumbar vertebral level/height2 (cm2/m2). Sarcopenia was defined by a psoas muscle mass index of under 5.03 cm2/m2 and 3.17 cm2/m2 in male and female patients, respectively. Post-operative prognosis and cumulative incidence of recurrence rates were calculated. Results The 5-year overall survival and disease-free survival rates post-surgery were 59.5% and 38.6%, respectively, in patients with sarcopenia versus 81.1% and 72.1%, respectively, in patients without sarcopenia (p < 0.001). The 5-year cumulative incidence of recurrence rate in patients with sarcopenia was significantly higher than those without sarcopenia (49.9% versus 22.4%, respectively) in every pathological stage. Pathological stages II and III (hazard ratio, 3.36; p = 0.004), histological type (hazard ratio, 2.31; p = 0.025), and sarcopenia (hazard ratio, 2.52; p = 0.001) were independent risk factors for post-operative recurrence according to multivariate analysis. Conclusion Sarcopenia is a risk indicator for post-operative recurrence in patients with non-small cell lung cancer.

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“…Recent studies have shown that sarcopenia has an impact on the prognosis of various cancers. The survival rate of patients with sarcopenia is signi cantly lower than that of patients with esophageal cancer (Jin et al, 2021), colorectal cancer (Xie et al, 2021), pancreatic cancer (Cho et al, 2021), lung cancer (Kawaguchi et al, 2021) without sarcopenia. In general, sarcopenia plays an important role in the prognosis of cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Systemic Inflammation with Sarcopenia Predict Survival in Patients with Gastric

Liu¹,

Ruan²,

Ge³

et al. 2021

Preprint

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Objective: The levels of platelet-related inflammation indicators and sarcopenia have been reported to affect the survival of patients with cancer. To evaluate the prognostic influence of platelet count (PLT), platelet–lymphocyte ratio (PLR), and systemic immune inflammation index (SII), and SII combined with sarcopenia on the survival of patients with gastric cancer (GC).Methods: A total of 1131 patients with GC (811 men and 320 women, average age: 59.45 years) were evaluated. Receiver operating characteristic curves were used to determine the best cut-off values of PLT, PLR, and SII, and univariate and multivariate Cox risk regression models were used to evaluate whether SII is an independent predictor of overall survival (OS). The prognostic SS (SII-sarcopenia) was established based on SII and sarcopenia. Finally, a comprehensive analysis of the prognostic SS was performed. Results: SII had the strongest prognostic effect. The SII and OS of patients with GC were in an inverted U-shape (adjusted HR = 1.06; 95% CI: 0.95-1.18; adjusted P = 0.271). In patients with SII >1800, SII was negatively correlated with OS (adjusted HR = 0.57; 95% CI: 0.29-1.12; adjusted P = 0.102), however, there is no statistical difference. Interestingly, a high SS was associated with a poorer prognosis. The higher the SS score, the worse the OS (P<0.001).Conclusion: SII is an independent prognostic indicator of GC, and high SII is related to poor prognosis. A Higher SS score had worse survival. Thus, the prognostic SS is a reliable predictor of OS in patients with GC.

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Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Cited by 30 publications

References 44 publications

Impact of sarcopenia on the prognosis and treatment of lung cancer: an umbrella review

Impact of sarcopenia on the prognosis and treatment of lung cancer: an umbrella review

Sarcopenia increases the risk of post-operative recurrence in patients with non-small cell lung cancer

Systemic Inflammation with Sarcopenia Predict Survival in Patients with Gastric

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