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

Lee, Chan Mi; Kang, Ju Young

doi:10.1002/jcsm.12575

Cited by 78 publications

(88 citation statements)

References 50 publications

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“…SMD is a widely used index for muscle quality and has been shown to be a prognosticator in cancer. 48 Moreover, SMD, but not SMI, was shown to be associated with physical function, 49 indicating that it may be a better marker for severe sarcopenia. However, the results of the present meta‐analysis demonstrated that SMD could not predict the survival in patients treated with ICIs.…”

Section: Discussionmentioning

confidence: 99%

Predictive impact of sarcopenia in solid cancers treated with immune checkpoint inhibitors: a meta‐analysis

Takenaka

Oya

Takemoto

et al. 2021

J cachexia sarcopenia muscle

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Sarcopenia, which is characterized by a decrease in muscle quantity or quality, is commonly observed in patients with cancer. Recent research has reported contradictory results on the association between sarcopenia and the efficacy of immune checkpoint inhibitors (ICIs). We conducted a systematic review and meta-analysis to investigate this discrepancy. We systematically searched three electronic databases to identify articles reporting on the association between sarcopenia and treatment outcomes in patients with solid cancers who received ICIs. The outcomes assessed were hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and odds ratios (ORs) for objective response rate (ORR), disease control rate (DCR), and toxicity. Pooled estimates and their 95% confidence intervals (CIs) were calculated. A total of 2501 patients from 26 studies were analysed. Sarcopenia was observed in 44.7% (95% CI: 38.2-51.3) of the patients and was significantly associated with poor survival (HR = 1.55, 95% CI = 1.32-1.82 for OS and HR = 1.61, 95% CI = 1.35 to 1.93 for PFS). The HRs (95% CIs) for OS according to the diagnostic measures used were 1.97 (0.88-4.41) for psoas muscle index (PMI), 1.41 (0.87-2.28) for skeletal muscle density (SMD), and 1.43 (1.23-1.67) for skeletal mass index (SMI). The HRs (95% CIs) for PFS were 1.86 (1.08-3.21) for PMI, 1.27 (0.94-1.71) for SMD, and 1.38 (1.11-1.71) for SMI. Poor radiological response to ICI therapy was observed in patients with sarcopenia (OR = 0.52, 95% CI = 0.34-0.80 for ORR and OR = 0.45, 95% CI = 0.30-0.67 for DCR). The ORs for ORR (95% CIs) were 0.56 (0.15-2.05) for PMI and 0.78 (0.56-1.09) for SMI. The oncologic outcomes associated with melanoma and non-small cell lung cancer (NSCLC) were comparable with those observed overall (HR for OS = 2.02, 95% CI = 1.26-3.24 for melanoma and HR for OS = 1.61, 95% CI = 1.19-2.18 for NSCLC). In contrast, the occurrence of severe toxicity was not associated with sarcopenia (OR = 1.13, 95% CI = 0.51-2.52). Poor survival and poor response in patients with sarcopenia indicate a negative association between sarcopenia and efficacy of ICIs. Sarcopenia's predictive ability is consistent across various tumour types. For the selection of patients who may respond to ICIs pre-therapeutically, the presence of sarcopenia should be assessed in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Predictive impact of sarcopenia in solid cancers treated with immune checkpoint inhibitors: a meta‐analysis

Takenaka

Oya

Takemoto

et al. 2021

J cachexia sarcopenia muscle

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“…Myosteatosis is a negative prognostic factor in cancer and has been associated with worse overall survival in a variety of cancers[ 82 , 83 ]. The pathophysiology of myosteatosis is not well understood, but it is believed that there is a relationship between aging and excess weight that results in ectopic fat deposition in skeletal muscle[ 84 ].…”

Section: Nutritional Status and Postoperative Complicationsmentioning

confidence: 99%

“…There are few recent studies of the effects of the change in body composition that occurs in myosteatosis. Better knowledge of the pathogenesis and validation of diagnostic criteria for myosteatosis are essential for conducting reliable studies to elucidate the impact of this condition on postoperative evolution and to accurately assess preoperative nutritional status[ 83 ].…”

Section: Nutritional Status and Postoperative Complicationsmentioning

confidence: 99%

Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

Rocha

Santos

Santana

2021

WJGPT

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Inflammatory bowel diseases (IBDs) are a group of chronic inflammatory diseases that affect the gastrointestinal tract, including Crohn's disease (CD) and ulcerative colitis. Surgery is a treatment option, and more than half of the patients with CD will undergo surgical interventions over the course of the disease. Postoperative complications are common in IBD patients, the most frequent being intra-abdominal sepsis, infection of the surgical site, and adynamic ileum, and nutritional status is a factor that can influence postoperative outcome. Recent studies have shown that malnutrition, obesity, sarcopenia, and myosteatosis are predictors of surgical complications. However, most were retrospective studies with small patient samples and heterogeneity of clinical and nutritional assessment methods, which limit the extrapolation of data. Therefore, knowing the pathophysiological mechanisms of IBD and identifying the best parameters for assessing nutritional status are essential for prompt implementation of adequate nutritional interventions.

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“…This apparent obesity paradox may be related to the reliance on BMI since this measure does not differentiate lean from fat mass or visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) [17,18], masking the relationship of fat mass with overall survival in men with prostate cancer [19,20]. Furthermore, sarcopenia or the loss of muscle mass has also been considered an important prognostic factor [6,[21][22][23], although its association with overall survival in men with prostate cancer is largely controversial depending on the cancer stage or phase of treatment [16,24,25]. Therefore, it remains to be determined if excess fat mass, reduced levels of muscle mass, or both treatment-related changes in body composition have an impact on overall survival in men with prostate cancer [20].…”

Section: Introductionmentioning

confidence: 99%

Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis

López

Newton

Taaffe

et al. 2021

Prostate Cancer Prostatic Dis

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Background To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer. Methods A systematic search was conducted in CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to December 2020, while abstracts from the American Society of Clinical Oncology (ASCO), Clinical Oncology Society of Australia (COSA), and the American College of Sports Medicine (ACSM) conferences were searched from 2014 to 2020. Eligible articles examined the association of body composition measures, such as fat mass (e.g., fat mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT) and muscle mass measures, with overall survival in prostate cancer patients at any treatment stage. The primary endpoint was overall survival. Random-effect meta-analysis was conducted for studies reporting multivariable or univariable analysis assessing the associations of fat mass measures (i.e., fat mass, VAT, SAT, VAT/SAT) and muscle mass measures with overall survival. Results Sixteen cohort studies that comprised 4807 men with prostate cancer were included. Total adiposity (hazard ratio (HR) 0.98, 95% CI: 0.75–1.28, p = 0.888) and VAT (HR 1.03, 95% CI: 0.74–1.43, p = 0.873) were not significantly associated with overall survival, while higher subcutaneous adipose tissue levels were associated with higher survival (HR 0.68, 95% CI: 0.54–0.84, p = 0.001). Greater mortality risk was found in patients with localised (HR 1.91, 95% CI: 1.40–2.62, p < 0.001) and advanced disease (HR 1.43, 95% CI: 1.07–1.92, p = 0.020) presenting with low levels of muscle mass compared to those presenting with high levels. Discussion These results indicate that although overall adiposity should be cautiously interpreted in regards to survival, high muscle mass and SAT, and low VAT/SAT ratio values are associated with overall survival in men with prostate cancer.

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

Cited by 78 publications

References 50 publications

Predictive impact of sarcopenia in solid cancers treated with immune checkpoint inhibitors: a meta‐analysis

Predictive impact of sarcopenia in solid cancers treated with immune checkpoint inhibitors: a meta‐analysis

Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

Associations of fat and muscle mass with overall survival in men with prostate cancer: a systematic review with meta-analysis

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