The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review

Boldyreva, Tatyana S.; Zatsepina, Alina Yurievna; Fedorinov, Denis S.; Lyadov, Vladimir

doi:10.1016/j.clnesp.2021.11.004

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…However, there is growing evidence suggesting sarcopenic obesity is associated with significant postoperative complications, reduced survival, and chemotherapy intolerance in many cancers, including gastrointestinal cancers. [17][18][19][20] It has been proposed that excessive adipose tissue could exacerbate sarcopenia by reducing skeletal muscle mass and muscle functionality due to fatty infiltration. 21 For patients with sarcopenic obesity, their large body weight can translate to a larger BSA, resulting in chemotherapy overdosing, supporting the importance of examining one's total body composition holistically rather than focusing on individual body compartments.…”

Section: Discussionmentioning

confidence: 99%

“…examined sarcopenic obesity (SMA to VAT area ratio) but found no association with DLT. However, there is growing evidence suggesting sarcopenic obesity is associated with significant postoperative complications, reduced survival, and chemotherapy intolerance in many cancers, including gastrointestinal cancers 17–20 . It has been proposed that excessive adipose tissue could exacerbate sarcopenia by reducing skeletal muscle mass and muscle functionality due to fatty infiltration 21 .…”

Section: Discussionmentioning

confidence: 99%

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The association of body composition on chemotherapy toxicities in non‐metastatic colorectal cancer patients: a systematic review

Choi,

Kin,

Cao

et al. 2023

ANZ Journal of Surgery

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BackgroundIn recent years, certain body composition measures, assessed by computed tomography (CT), have been found to be associated with chemotherapy toxicities. This review aims to explore available data on the relationship between skeletal muscle and adiposity, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular and intermuscular adipose tissue and their association with chemotherapy toxicity in non‐metastatic colorectal cancer (CRC) patients.MethodsA systematic literature search following PRISMA guidelines was conducted in Medline, Embase, Cochrane and Web of Science, for papers published between 2011 and 2023. The search strategy combined keywords and MESH terms relevant to ‘body composition’, ‘chemotherapy toxicities’, and ‘non‐metastatic colorectal cancer’.ResultsOut of 3868 studies identified, six retrospective studies fulfilled the inclusion criteria with 1024 eligible patients. Low skeletal muscle mass was strongly associated with increased incidence of both chemotherapy toxicities and dose‐limiting toxicity (DLT). The association of VAT, intramuscular and intermuscular adiposity was heterogeneous and inconclusive. There was no association between SAT and chemotherapy intolerance. No universal definitions or cut‐offs for sarcopenia and obesity were noted. All studies utilized 2‐dimensional (2D) CT slices for CT body composition assessment with varied selection on the vertebral landmark and inconsistent reporting of tissue‐defining Hounsfield unit (HU) measurements.ConclusionLow skeletal muscle is associated with chemotherapy toxicities in non‐metastatic CRC. However, quality evidence on the role of adiposity is limited and heterogeneous. More studies are needed to confirm these associations with an emphasis on a more coherent body composition definition and an approach to its assessment, especially regarding sarcopenia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The association of body composition on chemotherapy toxicities in non‐metastatic colorectal cancer patients: a systematic review

Choi,

Kin,

Cao

et al. 2023

ANZ Journal of Surgery

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Impact of sarcopenic obesity on postoperative outcomes in patients with oesophago‐gastric cancer: A systematic review and meta‐analysis

Matsui,

Yonezu,

Rifu

et al. 2024

World j. surg.

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BackgroundWe elucidated the influence of sarcopenic obesity on postoperative outcomes in patients with oesophago‐gastric cancer.MethodsWe conducted a systematic search on MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials.gov to identify observational studies published from their inception to September 26, 2024. Studies involving patients who underwent radical resection for oesophago‐gastric cancer and were evaluated for visceral fat mass and skeletal muscle mass through body composition were included in our analysis. The primary outcomes assessed were overall survival (OS) and postoperative complications. This protocol was registered in PROSPERO (CRD42023418403).ResultsUltimately, 13 studies (involving 4912 patients) were included in our qualitative and quantitative analyses. Among these studies, three were prospective cohort studies, while the remaining 10 were retrospective cohort studies. Twelve studies specifically investigated gastric cancer, while one focused on esophageal cancer. The prevalence of sarcopenic obesity ranged from 5.7% to 28.7%. Compared to the absence of sarcopenic obesity, its presence worsens OS (hazard ratio: 1.52, 95% confidence interval: 1.08–2.15, heterogeneity (I2) = 66%, certainty of the evidence: low) and increases the risk of postoperative complications (relative risk ratio: 1.88, 95% CI: 1.29–2.73, I2 = 77%, certainty of the evidence: moderate). The risk of bias in each study was deemed moderate to high.ConclusionsSarcopenic obesity worsens OS and increases the risk of postoperative complications in patients with oesophago‐gastric cancer undergoing radical resection.

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Sarcopenic obesity by the ESPEN/EASO criteria for predicting mortality in advanced non-small cell lung cancer

Zhou¹,

Luo²,

Xie³

et al. 2023

Clinical Nutrition

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The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review

Cited by 5 publications

References 33 publications

The association of body composition on chemotherapy toxicities in non‐metastatic colorectal cancer patients: a systematic review

The association of body composition on chemotherapy toxicities in non‐metastatic colorectal cancer patients: a systematic review

Impact of sarcopenic obesity on postoperative outcomes in patients with oesophago‐gastric cancer: A systematic review and meta‐analysis

Sarcopenic obesity by the ESPEN/EASO criteria for predicting mortality in advanced non-small cell lung cancer

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