Sarcopenia as a predictor of postoperative outcomes after urologic oncology surgery: A systematic review and meta-analysis

Guo, Zhenlang; Gu, Chiming; Gan, Shu; Li, Yuan; Xiang, Shulin; Gong, Leiliang; Chan, F.H.Y.; Wang, Shusheng

doi:10.1016/j.urolonc.2020.02.014

Cited by 17 publications

(9 citation statements)

References 54 publications

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“…Our previous report showed that the whole psoas volume was correlated with psoas area at the L3 level [2]. The present study revealed that a low PMI was associated with a poorer prognosis than a high PMI in penile cancer, findings that concurred with those of previous reports in other solid malignancies [8,[11][12][13][14]. However, our study did not describe the correlation between a lower PNI and other prognostic factors, including the pathological grade, T stage, Broders' grade, and Y-K grade [19,20].…”

Section: Discussionsupporting

confidence: 92%

“…Sarcopenia lowers the performance status and increases the prevalence of neurologic disease, chronic lung diseases, and virus infection [9,10]. Recent studies have revealed that a low PMI was associated with a poorer prognosis than a high PMI, including for cases of gastrointestinal, genitourinary, and gynecological cancers [8,[11][12][13][14]. However, no report has described the correlation between sarcopenia and penile cancer.…”

Section: Discussionmentioning

confidence: 99%

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A low psoas muscle volume is associated with a poor prognosis in penile cancer

et al. 2020

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Background: Sarcopenia was initially recognized as a marker representing the nutritional condition or aging. Recently, sarcopenia has been associated with a poor prognosis and postoperative complications. We examined the importance of sarcopenia as a predictive marker of the prognosis in penile cancer. Materials and Methods: A total of 25 patients diagnosed with penile cancer who underwent penile resection from 2000 to 2010 were analyzed in this study. The psoas muscle index (PMI) was calculated based on psoas area using preoperative axial computed tomography images at the right L3 level divided by the square of the body height. Results: Nineteen (76.0%) patients underwent partial penectomy, and 6 (24.0%) underwent total penectomy. The median (mean ± standard deviation) age was 69.3 (69.0 ± 10.1) years old. Regarding the site of penile cancer, 17 (76.0%) cases were in the glans, 6 (24.0%) were in the foreskin, and 2 (8.0%) were in the shaft. Lymph node metastasis were seen in 6 cases (24.0%), and distant metastasis was seen in 1 case (4.0%). The lower PMI group (< 320.0) showed a significantly poorer progression-free survival than the higher PMI group (≥ 320.0) (p = 0.030), although no significant difference in the overall survival was noted (p = 0.076). Conclusions: Sarcopenia might be a useful prognostic factor in penile cancer patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A low psoas muscle volume is associated with a poor prognosis in penile cancer

et al. 2020

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“…In 2020, a meta-analysis reported an elevated risk of complications and readmissions in patients with sarcopenia after any type of gastrointestinal surgery [ 39 ]. Similarly, another meta-analysis pointed out that sarcopenia independently predicted shorter survival and increased mortality among patients undergoing urologic oncology surgeries [ 40 ]. As lumbar spine surgeries inevitably cause various grades of the destruction of the paraspinal muscles, the dynamic stability over the axial skeleton would be further compromised, leading to more impairment of daily activities.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

Lee

Han

et al. 2021

JCM

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The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

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“…Sarcopenia and changes in muscle mass during a certain treatment period have been evaluated as important prognosticators in cancer patients [1][2][3][4][5]. The clinical importance of myosteatosis, which indicates the mean Hounsfield Unit of skeletal muscle measured using computed tomography (CT), has also been studied, and its association with oncologic outcomes has also been determined in patients with various types of cancers [6,7].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia’s Prognostic Impact on Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

Lee

Kim

et al. 2021

JCM

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Background: Although sarcopenia has been reported to predict survival in cancer patients, its impact on patients who received immune checkpoint inhibitors (ICIs) has not been thoroughly investigated. This systematic review aimed to assess the long-term oncologic impact of sarcopenia on patients who received ICIs. Methods: A systematic review of studies indexed in the PubMed, Embase, and Cochrane databases, up to April 1, 2021, was conducted. Studies that reported hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) based on sarcopenia in patients treated with ICIs were included. The inverse variance method was used with a random-effects model for data analysis. Results: A total of 1284 patients from 14 studies were included. Among the patients who received ICIs, patients with sarcopenia had a significant increase in overall mortality compared to patients without sarcopenia in univariate analyses (HR = 1.66, 95% CI = 1.20–2.29, p = 0.002) and in adjusted HRs (HR = 1.55, 95% CI = 1.15–2.10, p = 0.004). The same results were obtained for PFS by both univariate analysis (HR = 1.75, 95% CI = 1.37–2.23, p < 0.001) and adjusted HRs (HR = 1.63, 95% CI 1.28–2.09, p < 0.001). Conclusions: Sarcopenia appears to be an effective biomarker for predicting long-term oncologic outcomes in patients receiving ICI therapy and hence plays an important role when making treatment decisions. However, the fundamental role of this association with survival should be further investigated in large cohorts and clinical trials.

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Sarcopenia as a predictor of postoperative outcomes after urologic oncology surgery: A systematic review and meta-analysis

Cited by 17 publications

References 54 publications

A low psoas muscle volume is associated with a poor prognosis in penile cancer

A low psoas muscle volume is associated with a poor prognosis in penile cancer

The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

Sarcopenia’s Prognostic Impact on Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis

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