Pre-Therapeutic Sarcopenia among Cancer Patients: An Up-to-Date Meta-Analysis of Prevalence and Predictive Value during Cancer Treatment

Abstract

This study will address the prevalence of pre-therapeutic sarcopenia (PS) and its clinical impact during cancer treatment among adult cancer patients ≥ 18 years of age. A meta-analysis (MA) with random-effect models was performed via a MEDLINE systematic review, according to the PRISMA statement, focusing on articles published before February 2022 that reported observational studies and clinical trials on the prevalence of PS and the following outcomes: overall survival (OS), progression-free survival (PFS), post-operative complications (POC), toxicities (TOX), and nosocomial infections (NI). A total of 65,936 patients (mean age: 45.7–85 y) with various cancer sites and extensions and various treatment modes were included. Mainly defined by CT scan-based loss of muscle mass only, the pooled prevalence of PS was 38.0%. The pooled relative risks were 1.97, 1.76, 2.70, 1.47, and 1.76 for OS, PFS, POC, TOX, and NI, respectively (moderate-to-high heterogeneity, I2: 58–85%). Consensus-based algorithm definitions of sarcopenia, integrating low muscle mass and low levels of muscular strength and/or physical performance, lowered the prevalence (22%) and heterogeneity (I2 < 50%). They also increased the predictive values with RRs ranging from 2.31 (OS) to 3.52 (POC). PS among cancer patients is prevalent and strongly associated with poor outcomes during cancer treatment, especially when considering a consensus-based algorithm approach.

Association between dietary supplement use and mortality in cancer survivors with different body mass index and frailty status: a cohort study

“…Comorbid conditions, such as heart disease, diabetes, arthritis, etc., may interact with cancer and its treatment, potentially increasing the risk of mortality ( 25 ). Changes in physical performance and anthropometric measurements may be signs of declining bodily functions and malnutrition ( 40 ). Laboratory values can reflect systemic health issues that can directly affect the survival rates of cancer patients ( 41 ).…”

Independent and joint association of sarcopenia and frailty with mortality in older patients with gastrointestinal cancer: A cohort study with prospective data collection

“…Considering the EWGSOP2 criteria, we observed that the patients with sarcopenia had a 1.78 times higher risk of mortality compared to those without sarcopenia. Although important and extensively presented as a predictor of negative outcomes [25], the diagnosis of sarcopenia in clinical practice in oncology care remains not common. In our study, pre-sarcopenia (identi ed by low HGS) was an independent risk factor of mortality in older patients with gastrointestinal cancer.…”

Advances in the relationship between temporal muscle thickness and prognosis of patients with glioblastoma: a narrative review

“…Depending on the tumor type, sarcopenia may be present in 20-70% of cancer patients ( 20 ) and has a significant negative impact on patient health, physical function, and quality of life ( 21 ). It has been shown that sarcopenia is highly correlated with frailty, overall survival (OS), and progression-free survival (PFS) in cancer patients ( 27 ). From a surgical oncology perspective, the presence of sarcopenia indicates that patients have limited reserves to deal with surgical stress and are more prone to complications ( 28 , 29 ), longer hospital stays ( 30 ), and higher mortality ( 31 ).…”