Radiologically Defined Sarcopenia Affects Survival in Head and Neck Cancer: A Meta‐Analysis

Wong, Amanda; Zhu, Daniel; Kraus, Dennis H.; Tham, Tristan

doi:10.1002/lary.28616

Cited by 72 publications

(85 citation statements)

References 42 publications

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“…Some studies have indicated that low skeletal muscle mass also predicted OS in HNSCC. 11 , 12 In agreement with these reports, the present meta-analysis based on a large cohort shows that sarcopenia was associated with lower OS. Remarkably, the calculated HRs among the studies do not differ largely.…”

Section: Discussionsupporting

confidence: 92%

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Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Surov

Wienke

2021

Ther Adv Med Oncol

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Background: The purpose of this meta-analysis was to analyze the influence of sarcopenia, defined as low skeletal muscle mass, on clinical outcomes in patients with head and neck squamous cell carcinoma (HNSCC) based on a large sample. Methods: The MEDLINE, EMBASE, and SCOPUS databases were screened for associations between sarcopenia and clinical outcomes in HNSCC up to December 2020. Overall, 27 studies met the inclusion criteria. The methodological quality of the studies involved was checked according to the QUADAS instrument. The meta-analysis was undertaken using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used to account for heterogeneity between the studies. Results: The 27 included studies comprised 7704 patients with different HNSCCs. The cumulative calculated frequency among the studies was 42.0% [95% confidence interval (CI) 35.34–48.65]. Sarcopenia was associated with occurrence of severe postoperative complications, odds ratio (OR) 4.79, 95% CI (2.52–9.11), p < 0.00001. Sarcopenia predicted disease-free survival (DFS), simple regression: hazard ratio (HR) 2.00, 95% CI (1.63–2.45), p < 0.00001, multiple regression: HR 1.64, 95% CI (1.33–2.03), p < 0.00001. Also, sarcopenia was associated with lower overall survival (OS), simple regression: HR 1.96, 95% CI (1.71–2.24), p < 0.00001, multiple regression: HR = 1.87, 95% CI (1.53–2.29), p < 0.00001. In patients who underwent definitive chemotherapy and/or radiation, sarcopenia predicted lower OS (simple regression), HR 1.95, 95% CI (1.61–2.36), p < 0.00001, multiple regression: HR = 1.51, 95% CI (1.17–1.94), p < 0.002). In patients with primary surgical strategy with or without adjuvant radio-chemotherapy, sarcopenia was associated with lower OS (simple regression), HR 2.21, 95% CI (1.72–2.84), p < 0.00001, multiple regression: HR = 2.05, 95% CI (1.55–2.72), p < 0.00001). Conclusion: The cumulative prevalence of sarcopenia in HNSCC is 42.0%. Sarcopenia is an independent risk factor for OS and DFS in patients with HNSCC who undergo curative therapy. Sarcopenia is associated with the occurrence of severe postoperative complications.

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Section: Discussionsupporting

confidence: 92%

“… 10 Some authors indicated that sarcopenia defined as LSMM can also play an essential role also in HNSCC. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Surov

Wienke

2021

Ther Adv Med Oncol

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“…Then, we chose the newest meta‐analysis with the largest number of studies. Finally, 54 health‐related outcomes extracted from 30 meta‐analyses 10,22‐50 were reported in this umbrella review. These 54 outcomes were mainly about prognostic outcomes of tumor, postoperative outcomes, age‐related outcomes, metabolic outcomes, and other outcomes.…”

Section: Resultsmentioning

confidence: 99%

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

et al. 2020

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Objective The purpose of this umbrella review was to assess the associations between sarcopenia and adverse health‐related outcomes. Design An umbrella review of meta‐analyses of observational studies. Setting and Participants Patients with sarcopenia and controls without sarcopenia were included. Measures The PubMed, Web of Science and Embase were searched for relevant systematic review and meta‐analysis. AMSTAR and GRADE system were used for methodological quality and evidence quality assessments, respectively. Results Totally 54 outcomes extracted from 30 meta‐analyses were analyzed. Twenty out of 21 prognostic outcomes indicated that sarcopenia was significantly associated with poorer prognosis of gastric cancer, hepatocellular cancer, urothelial cancer, head and neck cancer, hematological malignancy, pancreatic cancer, breast cancer, colorectal cancer, lung cancer, esophageal cancer, and ovarian cancer. Besides, 10 out of 16 postoperative outcomes suggested that sarcopenia significantly increased the risk of multiple postoperative complications and prolonged the length of hospitalization of patients with digestive cancer. In age‐related outcomes, sarcopenia significantly increased the risk of dysphagia, cognitive impairment, fractures, falls, hospitalization, and all‐cause mortality of elderly populations. Moreover, sarcopenia was also associated with higher level of albuminuria, risk of depression, and several metabolic diseases. Conclusions and Implications Sarcopenia significantly affected a wide range of adverse health‐related outcomes, particularly in patients of tumor and elderly populations. Because evidences of most outcomes were rated as “low” and “very low,” more prospective cohort studies are required in the future.

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“…Martin et al [ 36 ] have highlighted the need for standardized nutrition care pathways with clearly defined roles and responsibilities. Further, the prognostic significance of cancer-related malnutrition and sarcopenia [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ] in these patients warrants specific attention. The Clinical Oncology Society of Australia (COSA) have recently articulated a Position Statement to support the implementation of a co-ordinated, multidisciplinary pathway for screening, assessment and treatment of these conditions [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)

et al. 2020

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Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (n = 119) or EC (n = 51) in 11 cancer care settings in North America, Europe and Australia between 2016 and 2018. Adherence criteria were derived from relevant EBG recommendations with pooled results for participating centres reported according to the Nutrition Care Model at either system or patient levels. Adherence to EBG recommendations was: good (≥80%) for performing baseline nutrition screening and assessment, perioperative nutrition assessment and nutrition prescription for energy and protein targets; moderate (≥60 to 80%) for utilizing validated screening and assessment tools and pre-radiotherapy dietitian consultation; and poor (60%) for initiating post-operative nutrition support within 24 h and also dietetic consultation weekly during radiotherapy and fortnightly for 6 weeks post-radiotherapy. In conclusion, gaps in evidence-based cancer nutrition care remain; however, this may be improved by filling known evidence gaps through high-quality research with a concurrent evolution of EBGs to also encompass practical implementation guidance. These should aim to support multidisciplinary cancer clinicians to close evidence–practice gaps throughout the patient care trajectory with clearly defined roles and responsibilities that also address patient-reported concerns.

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Radiologically Defined Sarcopenia Affects Survival in Head and Neck Cancer: A Meta‐Analysis

Cited by 72 publications

References 42 publications

Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Low skeletal muscle mass predicts relevant clinical outcomes in head and neck squamous cell carcinoma. A meta analysis

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)

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