Myosteatosis and prognosis in cancer: Systematic review and meta-analysis

Aleixo, Gabriel F. P.; Shachar, Shlomit Strulov; Nyrop, Kirsten A.; Muss, Hyman B.; Malpica, Luis; Williams, Grant R.

doi:10.1016/j.critrevonc.2019.102839

Cited by 200 publications

(188 citation statements)

References 82 publications

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“…9,31 However, there are also studies reporting no prognostic impact of myosteatosis in patients with CRC, 27,34 which prompted us to look into whether myosteatosis was an independent risk factor as in the case for sarcopenia. Although there was a large meta-analysis looking at myosteatosis and prognosis in multiple cancer types, 13 detailed analysis is still required for CRC because of its prevalence and controversies of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The Newcastle-Ottawa scale scoring for cohort studies for the meta-analysis of myosteatosis in CRC has already been published. 13,24 The Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the methodology of included studies, by considering each of the domains outlined by Hayden et al 25 and rating for whether the study was conducted in a way to limit the potential bias (yes, no, partly, or unclear). In this systematic review, studies that were identified as having an overall high risk of bias were those that did not have clear criteria for myosteatosis and did not perform statistical analyses such as multivariate analyses to account for potential confounding factors.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…4,8,12 A recent study has shown that myosteatosis is associated with shorter survival in multiple cancer types. 13 However, there were other studies not showing clear association between myosteatosis and survival for patients with CRC. 8,14 To reconcile these findings and to consolidate the role of myosteatosis as a possible prognostic factor in CRC, a review of the existing evidence thus far seemed timely and appropriate.…”

Section: Introductionmentioning

confidence: 98%

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Prognostic impact of myosteatosis in patients with colorectal cancer: a systematic review and meta‐analysis

Lee

Kang

2020

J cachexia sarcopenia muscle

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Background Myosteatosis has been reported to be a novel biomarker that could predict survival outcomes in patients with colorectal cancer. However, results have been conflicting. This systematic review and meta-analysis aimed to evaluate the long-term impact of myosteatosis on the survival of these patients. Methods A systematic search of PubMed, Embase, and Cochrane up to 27 November 2019 generated 7022 records. Studies that reported hazard ratio (HR) for overall survival, cancer-specific survival, or disease-free survival based on myosteatosis or radiodensity were included. A total of 110 full-text articles were considered for inclusion, and 14 were selected for qualitative analysis. Inverse variance method was used with random effects model for data analysis. Results The total number of enrolled patients included in the meta-analysis was 6518 for univariate and 8572 for multivariate HR analysis, from 12 and 10 studies, respectively. Patients with myosteatosis had a significant increase in overall mortality compared with non-myosteatosis patients by both univariate analysis [

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Section: Discussionmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Prognostic impact of myosteatosis in patients with colorectal cancer: a systematic review and meta‐analysis

Lee

Kang

2020

J cachexia sarcopenia muscle

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“…We chose the Martin et al definition because it was the first pivotal study to address SMD in oncology and it is the most commonly employed in the literature. 17 Total adipose tissue index (TATI) was used to normalize adipose tissue for height and was calculated as follows: (subcutaneous adipose tissue area (cm 2 ) +visceral adipose tissue area (cm 2 ))/(height (m 2 )). We used tertiles to categorize TATI because there is no clinically established threshold for TATI and we felt that tertiles would be the most appropriate way to categorize a continuous variable without an established threshold.…”

Section: Methodsmentioning

confidence: 99%

Impact of body composition on outcomes from anti-PD1 +/− anti-CTLA-4 treatment in melanoma

Young

Quach

Song

et al. 2020

J Immunother Cancer

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BackgroundImmune checkpoint inhibitors (ICIs) have transformed treatment for melanoma, but identifying reliable biomarkers of response and effective modifiable lifestyle factors has been challenging. Obesity has been correlated with improved responses to ICI, although the association of body composition measures (muscle, fat, etc) with outcomes remains unknown.MethodsWe performed body composition analysis using Slice-o-matic software on pretreatment CT scans to quantify skeletal muscle index (SMI=skeletal muscle area/height2), skeletal muscle density (SMD), skeletal muscle gauge (SMG=SMI × SMD), and total adipose tissue index (TATI=subcutaneous adipose tissue area + visceral adipose tissue area/height2) of each patient at the third lumbar vertebrae. We then correlated these measures to response, progression-free survival (PFS), overall survival (OS), and toxicity.ResultsAmong 287 patients treated with ICI, body mass index was not associated with clinical benefit or toxicity. In univariable analyses, patients with sarcopenic obesity had inferior PFS (HR 1.4, p=0.04). On multivariable analyses, high TATI was associated with inferior PFS (HR 1.7, p=0.04), which was particularly strong in women (HR 2.1, p=0.03). Patients with intermediate TATI and high SMG had the best outcomes, whereas those with low SMG/high TATI had inferior PFS and OS (p=0.02 for both PFS and OS).ConclusionsBody composition analysis identified several features that correlated with improved clinical outcomes, although the associations were modest. As with other studies, we identified sex-specific associations that warrant further study.

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“…Low muscle mass is closely associated with poor short- and long-term clinical outcomes in cancer patients, including increased rate of surgical complications, chemotherapy-related toxicity, and reduced survival [ 3 , 13 ], and a predictive value of reduced skeletal muscularity in cancer-related morbidity and mortality has been convincingly demonstrated by many studies [ 6 , 13 ]. Further investigations have shown that low muscle radiation attenuation as assessed by computed tomography is associated with fat infiltration, and this phenomenon is linked with poor prognosis in some types of cancers [ 14 , 15 ]; fat infiltration (also known as myosteatosis) has therefore been intensively investigated in an effort to improve the prognostic accuracy of altered body composition during cancer and related therapies [ 16 ]. Although low muscle strength is recognized as a key component of a patient’s functional status and QoL and is a potential therapeutic target [ 17 ], standardized cut offs for low muscle strength have not yet been identified in the definition of cancer-associated cachexia and sarcopenia [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Protein Supplementation Targeted at Improving Muscle Mass on Strength in Cancer Patients: A Scoping Review

Zanetti¹,

Cappellari²,

Barazzoni³

et al. 2020

Nutrients

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Deterioration of muscle strength during cancer results in functional limitation, poor quality of life and reduced survival. The indirect effects on muscle strength of nutritional interventions based on protein and amino acid derivatives targeted at improving muscle mass are poorly documented. A scoping review was performed to examine the available evidence on the effects of proteins, amino acids and their derivatives on muscle strength in adult cancer patients. Pubmed and Scopus databases were searched to identify research articles published in the last 10 years. Fourteen studies met the inclusion criteria, showing that changes in muscle strength following protein or amino acid supplementation are generally concordant with those in muscle mass in cancer patients. Administration of both energy and proteins in the presence of reduced oral intakes results in more robust effects on both muscle strength and mass. It is not clear whether this is due to the correction of the energy deficit or to an interaction between proteins and other macronutrients. The optimal mixture, type, and dose of amino acid/protein supplementation alone or in combination with other anabolic strategies should be determined to provide the best nutritional approach in cancer.

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Myosteatosis and prognosis in cancer: Systematic review and meta-analysis

Cited by 200 publications

References 82 publications

Prognostic impact of myosteatosis in patients with colorectal cancer: a systematic review and meta‐analysis

Prognostic impact of myosteatosis in patients with colorectal cancer: a systematic review and meta‐analysis

Impact of body composition on outcomes from anti-PD1 +/− anti-CTLA-4 treatment in melanoma

The Impact of Protein Supplementation Targeted at Improving Muscle Mass on Strength in Cancer Patients: A Scoping Review

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