Prevalence and clinical outcomes of sarcopenia in patients with esophageal, gastric or colorectal cancers receiving preoperative neoadjuvant therapy: A meta-analysis

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-04-01 DOI:10.1016/j.apjon.2024.100436

Lin Luo , Yidan Fan , Yanan Wang , Zhen Wang , Jian Zhou

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Abstract

Objective

To investigate the prevalence of sarcopenia and its impact on clinical outcomes in patients with esophageal, gastric, or colorectal cancer (EC, GC, and CRC) receiving neoadjuvant therapy through Meta-analysis.

Methods

We searched the PubMed, Embase databases, and Cochrane Library for the prevalence of sarcopenia and its impact on clinical outcomes in EC, GC, or CRC patients treated with neoadjuvant therapy (NAT) from inception to November 2022. The primary endpoints were the prevalence of sarcopenia and overall survival in patients with EC, GC, or CRC treated with NAT. Secondary outcomes included recurrence-free survival, total postoperative complications, grade 3–4 chemotherapy toxicity, and 30-day mortality after surgery.

Results

Thirty-one retrospective studies with 3651 subjects were included. In a fixed-effects model, the prevalence of muscle loss was higher in patients with EC, GC, or CRC at 50% (95% CI = 42% to 58%). The results of the multivariate analysis showed that preoperative patients with sarcopenia had a 1.91 times shorter overall survival (95% CI = 1.61–2.27) and a 1.77 times shorter recurrence-free survival time (95% CI = 1.33–2.35) than patients without sarcopenia, and that patients with sarcopenia had a higher risk of total postoperative complications than patients without sarcopenia OR = 1.27 (95% CI = 1.03–1.57). However, the two groups had no statistical difference in grade 3–4 chemotherapy toxicity (P = 0.84) or 30-d postoperative mortality (P = 0.88).

Conclusions

The prevalence of sarcopenia in patients with EC, GC, or CRC during NAT is high, and it is associated with poorer clinical outcomes. Clinicians should closely monitor the changes in patients’ body composition and guide patients to carry out a reasonable diet and appropriate exercise to improve their poor prognosis and quality of life.

Systematic review registration

CRD42023387817.

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接受术前新辅助治疗的食管癌、胃癌或结直肠癌患者中肌肉疏松症的患病率和临床结果：荟萃分析

方法我们在 PubMed、Embase 数据库和 Cochrane 图书馆中搜索了从开始到 2022 年 11 月接受新辅助治疗（NAT）的食管癌、胃癌或结肠直肠癌患者中肌肉疏松症的患病率及其对临床结果的影响。主要终点是接受 NAT 治疗的 EC、GC 或 CRC 患者的肌肉疏松症患病率和总生存率。次要结果包括无复发生存率、术后总并发症、3-4 级化疗毒性以及术后 30 天死亡率。在固定效应模型中，EC、GC或CRC患者的肌肉缺失率较高，为50%（95% CI = 42%至58%）。多变量分析结果显示，与无肌肉疏松症的患者相比，术前患有肌肉疏松症的患者的总生存期缩短了1.91倍（95% CI = 1.61-2.27），无复发生存期缩短了1.77倍（95% CI = 1.33-2.35），而患有肌肉疏松症的患者出现术后总并发症的风险也高于无肌肉疏松症的患者，OR = 1.27（95% CI = 1.03-1.57）。然而，两组患者在 3-4 级化疗毒性（P = 0.84）或术后 30 天死亡率（P = 0.88）方面没有统计学差异。临床医生应密切关注患者身体成分的变化，指导患者进行合理饮食和适当运动，以改善其不良预后和生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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