Prognostic Impact of Sarcopenia in Patients with Advanced Prostate Carcinoma: A Systematic Review

Abstract

Prostate cancer (PCa) is the second most common cancer in men and the fifth leading cause of death from cancer. The possibility of sarcopenia being a prognostic factor in advanced PCa patients has recently become a subject of interest. The aim of the present study was to evaluate the prognostic value of sarcopenia in advanced prostate carcinoma. A systematic review was conducted in Medline, EMBASE, and Web of Science (March, 2021). The quality of studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses for overall, cancer-specific, and progression-free survival were performed. Nine studies (n = 1659) were included. Sarcopenia was borderline associated with a shorter overall survival (HR = 1.20, 95% CI: 1.01, 1.44, P = 0.04, I2 = 43%) but was significantly associated with progression-free survival (HR = 1.61, 95% CI: 1.26, 2.06, P < 0.01; k = 3; n = 588). Available evidence supports sarcopenia as an important prognostic factor of progression-free survival in patients with advanced PCa. However, sarcopenia has a weak association with a shorter overall survival. The evidence on the role of sarcopenia in prostate-cancer-specific survival is insufficient and supports the need for further research. Patient summary: The literature was reviewed to determine whether the loss of muscle mass (sarcopenia) affects the survival in patients with advanced PCa. Patients with advanced PCa and sarcopenia were found to have a shorter progression-free survival (the length of time during and after treatment of a cancer that the patient lives with the disease but it does not get worse), but sarcopenia did not have much influence on the overall survival and cancer-specific survival (the length of time from either the date of diagnosis or the start of treatment to the date of death due to the cancer).

Influence of Androgen Deprivation Therapy on the Development of Sarcopenia in Patients with Prostate Cancer: A Systematic Review

“…The occurrence of sarcopenia is one of the negative prognostic factors for patients with PC and therefore highlights the importance of proper diet (rich in protein and proper energy value) during the treatment to improve the effectiveness of clinical treatment. It has been proven that cancer-progression-free survival for patients with PCa and sarcopenia is shorter [ 35 ]. The current results are consistent with those obtained by other researchers [ 17 , 22 , 26 , 28 ].…”

“…In the analyzed studies, SMI showed a statistically significant decrease with an effect size of 0.38 (between moderate and large). Pablos-Rodríguez et al [ 35 ] highlighted that this parameter is crucial in terms of survival prognosis. The decrease in SMI directly affected survival ratio [ 25 ].…”

Clinical Course of Prostate Cancer and Factors That Determine It

“…На якість життя хворих з РПЗ у пізніх стадіях значно впливає розвиток саркопенії. Рівень саркопенії при РПЗ прямо корелює з концентрацією в крові маркерів пухлинного процесу -ISF1 та TS, відображаючи тяжкий перебіг пухлинного процесу, та є прогнозонегативним критерієм [14,15].…”

“…The development of sarcopenia significantly affects the quality of life of patients with PC in the late stages. The level of sarcopenia in PC is directly correlated with the concentration in the blood of markers of the tumour process -ISF1 and TS, reflecting the severe course of the tumour process and is a negative prognostic criterion [14,15].…”