Sarcopenia, Obesity, and Outcomes Following Hepatic Resection for Colorectal Liver Metastases: A Systematic Review

O’Connell, R.M.; O’Neill, Michael F.; Ríordáin, M.Ó.; Suilleabhain, Criostoir O; O’Sullivan, AW

doi:10.1016/j.hpb.2022.05.216

Cited by 1 publication

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“…Our analysis did not include studies that incorporated mixed populations due to their heterogenic nature in planning. This might explain this difference in one of our main findings compared to a recent meta-analysis incorporating all liver tumors (37,45).…”

Section: Figurecontrasting

confidence: 72%

“…To the best of our knowledge, this is the first meta-analysis that deals with the influence of sarcopenia on the outcome of patients who undergo liver resection for colorectal liver metastases (CRLM) alone. CRLM patients have been incorporated into previous metaanalyses (36,37). However, due to the unique nature of CRLM and its rising incidence, preoperative assessment is more and more valued in this patient cohort (38).…”

Section: Discussionmentioning

confidence: 99%

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Value of sarcopenia in the resection of colorectal liver metastases—a systematic review and meta-analysis

Wagner,

Wienerroither,

Scherrer

et al. 2023

Front. Oncol.

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IntroductionSarcopenia is defined as a decline in muscle function as well as muscle mass. Sarcopenia itself and sarcopenic obesity, defined as sarcopenia in obese patients, have been used as surrogates for a worse prognosis in colorectal cancer. This review aims to determine if there is evidence for sarcopenia as a prognostic parameter in colorectal liver metastases (CRLM).MethodsPubMed, Embase, Cochrane Central, Web of Science, SCOPUS, and CINAHL databases were searched for articles that were selected in accordance with the PRISMA guidelines. The primary outcomes were overall survival (OS) and disease-free survival (DFS). A random effects meta-analysis was conducted.ResultsAfter eliminating duplicates and screening abstracts (n = 111), 949 studies were screened, and 33 publications met the inclusion criteria. Of them, 15 were selected after close paper review, and 10 were incorporated into the meta-analysis, which comprised 825 patients. No significant influence of sarcopenia for OS (odds ratio (OR), 2.802 (95% confidence interval (CI), 1.094–1.11); p = 0.4) or DFS (OR, 1.203 (95% CI, 1.162–1.208); p = 0.5) was found, although a trend was defined toward sarcopenia. Sarcopenia significantly influenced postoperative complication rates (OR, 7.905 (95% CI, 1.876–3.32); p = 0.001) in two studies where data were available.ConclusionExisting evidence on the influence of sarcopenia on postoperative OS as well as DFS in patients undergoing resection for CRLM exists. We were not able to confirm that sarcopenic patients have a significantly worse OS and DFS in our analysis, although a trend toward this hypothesis was visible. Sarcopenia seems to influence complication rates but prospective studies are needed.

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Section: Figurecontrasting

confidence: 72%