Sarcopenia and Short-Term Outcomes After Esophagectomy: A Meta-analysis

Wang, Peiyu; Xu, Lidong; Chen, Xiankai; Xu, Liping; Yu, Yonghao; Zhang, Rui-Xiang; Sun, Haibo; Wu, Huili; Yin, Li

doi:10.1245/s10434-020-08236-9

Cited by 45 publications

(33 citation statements)

References 28 publications

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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%

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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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Section: Resultsmentioning

confidence: 99%

“…Totally 16 postoperative outcomes of tumors were reported 10,25,33‐35 . For esophageal cancer, patients with sarcopenia had significantly higher risk of overall postoperative complications and pulmonary complications, while no association was found with anastomotic leakage.…”

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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“…Although the exact criteria to define it differ, reduced skeletal muscle mass is a fundamental feature across all definitions. There is robust evidence for an impaired immune response in patients with sarcopenia, including a higher incidence of community-acquired and in-hospital pneumonia, and an increased risk of infectious complications following surgeries [14, 17, 18]. A key mechanism underlying the impaired immunity in individuals with sarcopenia refers to the abnormal myokines, such as interleukin (IL)-15, IL-17, and IL-6, which modulate the proliferation and function of both innate and adaptive immune cells [29].…”

Section: Discussionmentioning

confidence: 99%

“…The role of skeletal muscle mass in modulating immune response and supporting metabolic stress responses are well documented. Patients with sarcopenia have been shown to have compromised intercostal muscle strength and respiratory function, which are detrimental in the treatment of severe pneumonia and acute respiratory distress syndrome [16], have higher incidence of community-acquired and in-hospital pneumonia, and are reported to have reduced ability to respond to systemic stress when facing acute infection, major surgeries, and other illness [14, 17, 18]. Currently, no study has investigated the relationship between sarcopenia and COVID-19 risk [14].…”

Section: Introductionmentioning

confidence: 99%

Sarcopenic obesity and the risk of hospitalisation or death from COVID-19: findings from UK Biobank

Wilkinson

Yates

Baker

et al. 2021

Preprint

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BackgroundCoronavirus disease□2019 (COVID□19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS□CoV□2 virus). The role of skeletal muscle mass in modulating immune response is well documented. Whilst obesity is well-established as a key factor in COVID-19 infection and outcome, no study has examined the influence of both sarcopenia (low muscle mass) and obesity, termed ‘sarcopenic obesity’ on COVID-19 risk.MethodsThis study uses data from UK Biobank. Probable sarcopenia was defined as low handgrip strength. Sarcopenic obesity was mutually exclusively defined as the presence of obesity and low muscle mass (based on two established criteria: appendicular lean mass (ALM) adjusted for either: 1) height and 2) body mass index (BMI)). ‘Severe COVID-19’ was defined by a positive test result in a hospital setting or death with a primary cause reported as COVID-19. Fully adjusted logistic regression models were used to analyse the associations between sarcopenic status and severe COVID-19. This work was conducted under UK Biobank application number 52553.ResultsWe analysed data from 490,301 UK Biobank participants. 2203 (0.4%) had severe COVID-19 infection. Individuals with probable sarcopenia were 64% more likely to have had severe COVID-19 infection (odds ratio (OR) 1.638; P<.001). Obesity increased the likelihood of severe COVID-19 infection by 76% (P<.001). Using either ALM index and ALM/BMI index to define low muscle mass, those with sarcopenic obesity were 2.6 times more likely to have severe COVID-19 (OR: 2.619; P<.001). Sarcopenia alone did not increase the risk of COVID-19.ConclusionsSarcopenic obesity may increase the risk of severe COVID-19 infection, over that of obesity alone. The mechanisms for this are complex but could be a result of a reduction in respiratory functioning, immune response, and ability to respond to metabolic stress.

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“…In patients with esophageal cancer, skeletal muscle mass has been assessed to investigate whether the presence of preoperative sarcopenia impacts short-and long-term outcomes. A recent review of esophageal cancer showed that preoperative sarcopenia is a signi cant risk factor for postoperative complications, including respiratory complications and anastomotic leakage, and survival [10,11]. A recent study reported that skeletal muscle mass decreases progressively after esophagectomy, with the prevalence of sarcopenia increasing [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Postoperative Oral Intake Status on Sarcopenia Six Months After Esophageal Cancer Surgery

Hijikata

Ishikawa

Matsuda

et al. 2021

Preprint

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Purpose: In patients with esophageal cancer, skeletal muscle mass has been reported to decrease progressively after surgery and be independently associated with a poor prognosis. The purpose of this study was to investigate perioperative changes in dysphagia, oral intake status, and nutritional status and identify factors related to sarcopenia six months after esophagectomy.Methods: A total of 134 patients who underwent radical resection for thoracic esophageal cancer between March 2016 and July 2019 were analyzed retrospectively. The diagnosis of sarcopenia was made by CT taken six months postoperatively using the cut-off criteria of skeletal muscle index (SMI) <52.4 cm2/m2 for male and SMI <38.5 cm2/m2 for female patients. As factors related to postoperative sarcopenia, dysphagia, oral intake status, nutritional status, and physical function were extracted from the medical records. Multivariate logistic regression analysis was performed to identify perioperative risk factors related to sarcopenia six months after surgery.Results: Of the 134 patients, 34.3% were judged to be unable to start oral intake on swallowing assessment. At discharge, 30.6% received tube feeding with or without oral intake. In the non-oral intake group on swallowing assessment, a significantly higher proportion of patients received tube feeding at discharge (p=0.014). Preoperative BMI, postoperative handgrip strength, and tube feeding at discharge were independent risk factors for sarcopenia six months after esophagectomy in male patients.Conclusions: Oral intake status at discharge is significantly related to postoperative sarcopenia in patients with esophageal cancer. Identifying high-risk groups might allow early detection of malnutrition and provision of appropriate care.

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Sarcopenia and Short-Term Outcomes After Esophagectomy: A Meta-analysis

Cited by 45 publications

References 28 publications

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

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

Sarcopenic obesity and the risk of hospitalisation or death from COVID-19: findings from UK Biobank

Effect of Postoperative Oral Intake Status on Sarcopenia Six Months After Esophageal Cancer Surgery

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