Preoperative computed tomography-assessed sarcopenia as a predictor of complications and long-term prognosis in patients with colorectal cancer: a systematic review and meta-analysis

Xie, Hailun; Wei, Lishuang; Liu, Mingxiang; Yuan, Guanghui; Tang, Shaohui; Gan, Jialiang

doi:10.1007/s00423-021-02274-x

Cited by 27 publications

(18 citation statements)

References 48 publications

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“…Of the studies combining different malignancies [30,32,49], two did not refer to SMI as a measure of sarcopenia alone, but Berardi et al used the combination of reduced muscle mass and strength as a definition of LSMM, while Valero et al applied TPA and TPV. Our overall results exhibit a somewhat lower OR for post-operative complications for liver resection than those published for gastrectomy or surgery for CRC [13,14].…”

Section: Discussioncontrasting

confidence: 45%

“…With regard to complications after surgery, an association between LSMM and post-operative outcomes according to the Clavien Dindo score was reported for cancer patients after gastrectomy (OR 2.17, 95% CI 1.53-3.08) [13] and surgery for colorectal cancer (OR = 1.82, 95% CI = 1.36-2.44) [14]. Single studies have found LSMM to be associated with post-operative complications for pancreatic cancer [42], yet a meta-analysis did not find a significant association (OR 0.96, 95% CI 0.78-1.19) [17].…”

Section: Discussionmentioning

confidence: 99%

“…The influence of LSMM on post-operative complications for cancer patients has been shown in meta-analyses for gastric cancer (OR 2.17, 95% CI 1.53-3.08) [13] and colorectal cancer (OR = 1.82, 95% CI = 0.36-2.44) [14]. In esophageal cancer, pre-operative LSMM was associated with higher rates of post-operative pulmonary complications (OR 2.03, 95% CI 1.32-3.119), but not with higher rates of complications as defined by Clavien Dindo (OR 1.19, 95% CI 0.78 to 1.81) [15,16].…”

Section: Introductionmentioning

confidence: 96%

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Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

Thormann

Omari

Pech

et al. 2022

Langenbecks Arch Surg

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Purpose To assess the influence of low skeletal muscle mass (LSMM) on post-operative complications in patients with hepatic malignancies grade (Clavien Dindo ≥ 3) undergoing resection. Methods MEDLINE, Cochrane, and SCOPUS databases were screened for associations between sarcopenia and major post-operative complications (≥ grade 3 according to Clavien-Dindo classification) after resection of different malignant liver tumors. RevMan 5.3 software was used to perform the meta-analysis. The methodological quality of the included studies was assessed according to the QUIPS instrument. Results The analysis included 17 studies comprising 3157 patients. Subgroup analyses were performed for cholangiocarcinoma (CCC), colorectal cancer (CRC) liver metastases, and hepatocellular carcinoma (HCC). LSMM as identified on CT was present in 1260 patients (39.9%). Analysis of the overall sample showed that LSMM was associated with higher post-operative complications grade Clavien Dindo ≥ 3 (OR 1.56, 95% CI 1.25–1.95, p < 0.001). In the subgroup analysis, LSMM was associated with post-operative complications in CRC metastases (OR 1.60, 95% CI 1.11–2.32, p = 0.01). In HCC and CCC sub-analyses, LSMM was not associated with post-operative complications in simple regression analysis. Conclusion LSMM is associated with major post-operative complications in patients undergoing surgery for hepatic metastases and it does not influence major post-operative complications in patients with HCC and CCC.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

Thormann

Omari

Pech

et al. 2022

Langenbecks Arch Surg

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“…Notably, skeletal muscle loss has been identified as an important factor affecting the prognosis of patients with cancer. 22 , 23 HGS is a simple and noninvasive indicator that reflects the muscle function of patients. Low HGS was reported to be associated with poor prognosis, providing additional information for the prognostic evaluation of patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

Combination of Nutritional Risk Index and Handgrip Strength on the Survival of Patients with Cancer Cachexia: A Multi- Center Cohort Study

Xie

Ruan

Zhang

et al. 2022

JIR

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The nutritional risk index (NRI) and handgrip strength (HGS) are useful indicators of nutritional and physical status, respectively, both of them can predict the prognosis of many cancers; however, the predictive accuracy of a single indicator is unsatisfactory. Whether the combination of NRI and HGS could enhance the stratification of the prognosis of patients with cancer cachexia. Patients and Methods:The study population was randomly divided into training and validation cohorts. We combined NRI and HGS and constructed the NRI-HGS score. Restricted cubic splines were used to assess the associations between NRI, HGS, and allcause mortality. The Kaplan-Meier method was used to calculate the survival probability of the patients. The Cox proportional hazards risk model was used to analyze survival and prognostic factors. Results: Low NRI and low HGS were independent predictors of poor prognosis in patients with cancer cachexia. The NRI-HGS score showed a better prognostic stratification than either NRI or HGS. The co-occurrence of low NRI and low HGS was associated with an approximately 1.8-fold increased risk of mortality. The NRI-HGS score could effectively distinguish patients with a poor prognosis at different pathological stages. Furthermore, we constructed a novel prognostic nomogram based on NRI and HGS. The concordance index and calibration plot confirmed that the nomogram had good prognostic accuracy. The area under the receiver operating characteristic curve of the nomogram reached >0.8, which was much higher than that of the traditional tumor-node-metastasis staging system. The nomogram provided better prognostic stratification for patients with cancer cachexia. Conclusion: Low NRI and low HGS are independent prognostic indicators in cancer cachexia. The combination of NRI and HGS improve prognostic stratification for patients with cancer cachexia. Our study suggests combining nutritional and physical status in future cachexia research.

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“…Sarcopenia has been identified as a poor prognostic marker in numerous cancers, including gastrointestinal tumors, lung cancer, head and neck cancer, and ovarian cancer [31][32][33][34][35][36][37][38][39][40][41]. It has been associated with increased post-operative complications, improved toxicity of systemic therapies, and decreased overall survival [17,[42][43][44]. Several meta-analyses among gynecological cancer patients showed an influence of sarcopenia on OS and progression-free survival (PFS).…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia does not limit overall survival after interstitial brachytherapy for breast cancer liver metastases

Thormann¹,

Heitmann²,

March³

et al. 2022

jcb

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Purpose: Sarcopenia has been identified as a prognostic marker of clinical outcomes in several diseases. However, the influence of sarcopenia on non-surgical local treatments in breast cancer liver metastases (BCLM) is unknown. Therefore, the purpose of this study was to assess the effect of sarcopenia among patients with BCLM undergoing interstitial brachytherapy (iBT). Aim of the study was to evaluate the influence of baseline computed tomography (CT) psoas body composition parameters, including psoas muscle area (PMA), psoas muscle index (PMI), muscle density, and skeletal muscle gauge (SMG) on clinical variables in patients undergoing image-guided iBT.Material and methods: Computed tomography scans of patients undergoing iBT for BCLM from 2006-2017 were retrospectively analyzed. PMA, PMI, and SMG were measured on pre-treatment CT scans. Parameters were associated with overall survival using logistic regression analysis.Results: Sixty patients were included in the analysis. 27 patients (45%) were considered sarcopenic. Median overall survival was 27 months (SD = 4.0 months). In univariate analysis, neither PMA (

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Preoperative computed tomography-assessed sarcopenia as a predictor of complications and long-term prognosis in patients with colorectal cancer: a systematic review and meta-analysis

Cited by 27 publications

References 48 publications

Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

Low skeletal muscle mass and post-operative complications after surgery for liver malignancies: a meta-analysis

Combination of Nutritional Risk Index and Handgrip Strength on the Survival of Patients with Cancer Cachexia: A Multi- Center Cohort Study

Sarcopenia does not limit overall survival after interstitial brachytherapy for breast cancer liver metastases

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