Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Zhang, Xiao Ming; Dou, Qing Li; Zeng, Yingchun; Yong-hua, Yang; Cheng, Andy S. K.; Zhang, Wen Wu

doi:10.1186/s12885-020-6645-6

Cited by 114 publications

(105 citation statements)

References 45 publications

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“…Previous literature have identified significant associations in patients with lung cancer [ 10 ], head and neck cancer [ 11 , 18 ], GI cancer [ 9 , 19 , 20 ], liver cancer [ 9 , 21 , 22 ], pancreatic cancer [ 23 ], and urinary tract cancer [ 24 ], with largely consistent effect sized identified in the current meta-analysis. However, other recently published meta-analyses by Zhang et al [ 25 ], Ubachs et al [ 26 ], and Jia et al [ 27 ] have identified a significant association between sarcopenia and survival in breast cancer, ovarian cancer, and hematological malignancies, respectively, contrary to insignificant association identified in the current meta-analysis. The inconsistencies are likely due to fewer studies being included in our subgroup analysis, which could be attributed to differences in search strategy.…”

Section: Discussioncontrasting

confidence: 93%

Sarcopenia and mortality in cancer: A meta-analysis

Au¹,

Lee³

et al. 2021

Osteoporosis and Sarcopenia

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Objectives The aim of this meta-analysis is to comprehensively evaluate the effects of lean mass on all-cause mortality across different cancer types. Methods This is a meta-analysis. Cohort studies on lean mass and mortality published before December 20, 2017 were obtained by systematic search on PubMed, Cochrane Library, and Embase. Inclusion criteria were cohort studies reporting lean mass measurements by dual-energy X-ray absorptiometry, bioimpedance analysis or computed tomography, and with all-cause mortality as the study outcome. Exclusion criteria were studies using muscle mass surrogates, anthropometric measurement of muscle, rate of change in muscle mass, and sarcopenia defined by composite criteria. Hazard ratios (HRs) and 95% confidence intervals (CIs) of low/reduced lean mass on cancer mortality were pooled with a random-effects model. Subgroup analysis stratifying studies according to cancer type and measurement index was performed. Results Altogether 100 studies evaluated the association between lean mass and cancer mortality. The overall pooled HR on cancer mortality was 1.41 (95% CI, 1.24 to 1.59) for every standard deviation decrease in lean mass and 1.69 (95% CI, 1.56 to 1.83) for patients with sarcopenia (binary cutoffs). Overall mortality was also significantly associated with sarcopenia in across various cancer types, except for hematopoietic, breast, ovarian and endometrial, and prostate cancer. Conclusions The robust association of decreased lean mass with increased mortality further justified the importance of developing clinical guidelines for managing sarcopenia in cancer patients. Public health initiatives aiming at promoting awareness of muscle health in susceptible individuals are urgently needed.

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Section: Discussioncontrasting

confidence: 93%

Sarcopenia and mortality in cancer: A meta-analysis

Au¹,

Lee³

et al. 2021

Osteoporosis and Sarcopenia

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“…Then, we chose the newest meta‐analysis with the largest number of studies. Finally, 54 health‐related outcomes extracted from 30 meta‐analyses 10,22‐50 were reported in this umbrella review. These 54 outcomes were mainly about prognostic outcomes of tumor, postoperative outcomes, age‐related outcomes, metabolic outcomes, and other outcomes.…”

Section: Resultsmentioning

confidence: 99%

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

et al. 2020

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Objective The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health‐related outcomes. Design An umbrella review of meta‐analyses of observational studies. Setting and Participants Patients with sarcopenia and controls without sarcopenia were included. Measures The PubMed, Web of Science and Embase were searched for relevant systematic review and meta‐analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. Results Totally 54 outcomes extracted from 30 meta‐analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age‐related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all‐cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. Conclusions and Implications Sarcopenia significantly affected a wide range of adverse health‐related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as “low” and “very low,” more prospective cohort studies are required in the future.

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“…Around 30-50% of cancer-associated deaths are due to cachexia. During this process, metabolic changes occur; cancer cells behave like parasites, taking nutrition from the surrounding tissue leading to exhaustion of the body's energy resources [229]. Cancer-associated cachexia not only increases the rate of mortality but is also responsible for treatment failure [230,231].…”

Section: Cachexiamentioning

confidence: 99%

The Importance of Breast Adipose Tissue in Breast Cancer

Kothari

Diorio

Durocher

2020

IJMS

124

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Adipose tissue is a complex endocrine organ, with a role in obesity and cancer. Adipose tissue is generally linked to excessive body fat, and it is well known that the female breast is rich in adipose tissue. Hence, one can wonder: what is the role of adipose tissue in the breast and why is it required? Adipose tissue as an organ consists of adipocytes, an extracellular matrix (ECM) and immune cells, with a significant role in the dynamics of breast changes throughout the life span of a female breast from puberty, pregnancy, lactation and involution. In this review, we will discuss the importance of breast adipose tissue in breast development and its involvement in breast changes happening during pregnancy, lactation and involution. We will focus on understanding the biology of breast adipose tissue, with an overview on its involvement in the various steps of breast cancer development and progression. The interaction between the breast adipose tissue surrounding cancer cells and vice-versa modifies the tumor microenvironment in favor of cancer. Understanding this mutual interaction and the role of breast adipose tissue in the tumor microenvironment could potentially raise the possibility of overcoming breast adipose tissue mediated resistance to therapies and finding novel candidates to target breast cancer.

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Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Cited by 114 publications

References 45 publications

Sarcopenia and mortality in cancer: A meta-analysis

Sarcopenia and mortality in cancer: A meta-analysis

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

The Importance of Breast Adipose Tissue in Breast Cancer

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