Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review

Abstract Background Body composition plays an important role in predicting treatment outcomes in adults with cancer. Using existing computed tomographic (CT) cross-sectional imaging and readily available software, the assessment of skeletal muscle mass to evaluate sarcopenia has become simplified. W...

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Published in:European journal of cancer (1990) 2016-04, Vol.57, p.58-67
Main Authors: Shachar, Shlomit Strulov, Williams, Grant R, Muss, Hyman B, Nishijima, Tomohiro F
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Body Mass Index
Cancer
Female
Hematology, Oncology and Palliative Medicine
Humans
Kaplan-Meier Estimate
Male
Meta-analysis
Middle Aged
Neoplasms - mortality
Prognosis
Prognostic factor
Sarcopenia
Sarcopenia - etiology
Sarcopenia - mortality
Skeletal mass index (SMI)
Solid tumours
Survival
Systematic review
Young Adult
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cited_by cdi_FETCH-LOGICAL-c411t-b4825501d72324dddccd915caa8c653055c13aae7dfc964d0dcc2f0bcc9296ee3
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container_title European journal of cancer (1990)
container_volume 57
creator Shachar, Shlomit Strulov
Williams, Grant R
Muss, Hyman B
Nishijima, Tomohiro F
description Abstract Background Body composition plays an important role in predicting treatment outcomes in adults with cancer. Using existing computed tomographic (CT) cross-sectional imaging and readily available software, the assessment of skeletal muscle mass to evaluate sarcopenia has become simplified. We performed a systematic review and meta-analysis to quantify the prognostic value of skeletal muscle index (SMI) obtained from cross-sectional CT imaging on clinical outcomes in non-haematologic solid tumours. Methods We searched PubMed and the American Society Clinical Oncology online database of meeting abstracts up to October 2015 for relevant studies. We included studies assessing the prognostic impact of pre-treatment SMI on clinical outcomes in patients with non-haematologic solid tumours. The primary outcome was overall survival (OS) and the secondary outcomes included cancer-specific survival (CSS), disease-free survival (DFS), and progression-free survival (PFS). The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated. Results A total of 7843 patients from 38 studies were included. SMI lower than the cut-off was associated with poor OS (HR = 1.44, 95% CI = 1.32–1.56, p  
doi_str_mv 10.1016/j.ejca.2015.12.030
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Using existing computed tomographic (CT) cross-sectional imaging and readily available software, the assessment of skeletal muscle mass to evaluate sarcopenia has become simplified. We performed a systematic review and meta-analysis to quantify the prognostic value of skeletal muscle index (SMI) obtained from cross-sectional CT imaging on clinical outcomes in non-haematologic solid tumours. Methods We searched PubMed and the American Society Clinical Oncology online database of meeting abstracts up to October 2015 for relevant studies. We included studies assessing the prognostic impact of pre-treatment SMI on clinical outcomes in patients with non-haematologic solid tumours. The primary outcome was overall survival (OS) and the secondary outcomes included cancer-specific survival (CSS), disease-free survival (DFS), and progression-free survival (PFS). The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated. Results A total of 7843 patients from 38 studies were included. SMI lower than the cut-off was associated with poor OS (HR = 1.44, 95% CI = 1.32–1.56, p  &lt; 0.001). The effect of SMI on OS was observed among various tumour types and across disease stages. Worse CSS was also associated with low SMI (HR = 1.93, 95% CI = 1.38–2.70, p  &lt; 0.001) as well as DFS (HR = 1.16, 95% CI = 1.00–1.30, p  = 0.014), but not PFS (HR = 1.54, 95% CI = 0.90–2.64, p  = 0.117). Conclusions This meta-analysis demonstrates that low SMI at cancer diagnosis is associated with worse survival in patients with solid tumours. Further research into understanding and mitigating the negative effects of sarcopenia in adults with cancer is needed.</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2015.12.030</identifier><identifier>PMID: 26882087</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Cancer ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Kaplan-Meier Estimate ; Male ; Meta-analysis ; Middle Aged ; Neoplasms - mortality ; Prognosis ; Prognostic factor ; Sarcopenia ; Sarcopenia - etiology ; Sarcopenia - mortality ; Skeletal mass index (SMI) ; Solid tumours ; Survival ; Systematic review ; Young Adult</subject><ispartof>European journal of cancer (1990), 2016-04, Vol.57, p.58-67</ispartof><rights>Elsevier Ltd</rights><rights>2016 Elsevier Ltd</rights><rights>Copyright © 2016 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-b4825501d72324dddccd915caa8c653055c13aae7dfc964d0dcc2f0bcc9296ee3</citedby><cites>FETCH-LOGICAL-c411t-b4825501d72324dddccd915caa8c653055c13aae7dfc964d0dcc2f0bcc9296ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26882087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shachar, Shlomit Strulov</creatorcontrib><creatorcontrib>Williams, Grant R</creatorcontrib><creatorcontrib>Muss, Hyman B</creatorcontrib><creatorcontrib>Nishijima, Tomohiro F</creatorcontrib><title>Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Abstract Background Body composition plays an important role in predicting treatment outcomes in adults with cancer. Using existing computed tomographic (CT) cross-sectional imaging and readily available software, the assessment of skeletal muscle mass to evaluate sarcopenia has become simplified. We performed a systematic review and meta-analysis to quantify the prognostic value of skeletal muscle index (SMI) obtained from cross-sectional CT imaging on clinical outcomes in non-haematologic solid tumours. Methods We searched PubMed and the American Society Clinical Oncology online database of meeting abstracts up to October 2015 for relevant studies. We included studies assessing the prognostic impact of pre-treatment SMI on clinical outcomes in patients with non-haematologic solid tumours. The primary outcome was overall survival (OS) and the secondary outcomes included cancer-specific survival (CSS), disease-free survival (DFS), and progression-free survival (PFS). The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated. Results A total of 7843 patients from 38 studies were included. SMI lower than the cut-off was associated with poor OS (HR = 1.44, 95% CI = 1.32–1.56, p  &lt; 0.001). The effect of SMI on OS was observed among various tumour types and across disease stages. Worse CSS was also associated with low SMI (HR = 1.93, 95% CI = 1.38–2.70, p  &lt; 0.001) as well as DFS (HR = 1.16, 95% CI = 1.00–1.30, p  = 0.014), but not PFS (HR = 1.54, 95% CI = 0.90–2.64, p  = 0.117). Conclusions This meta-analysis demonstrates that low SMI at cancer diagnosis is associated with worse survival in patients with solid tumours. Further research into understanding and mitigating the negative effects of sarcopenia in adults with cancer is needed.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Cancer</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Neoplasms - mortality</subject><subject>Prognosis</subject><subject>Prognostic factor</subject><subject>Sarcopenia</subject><subject>Sarcopenia - etiology</subject><subject>Sarcopenia - mortality</subject><subject>Skeletal mass index (SMI)</subject><subject>Solid tumours</subject><subject>Survival</subject><subject>Systematic review</subject><subject>Young Adult</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1TAQRS0Eoq-FP8ACeckmwXa-HISQqqoUpEogAWvLbzwBhyR-eJxW79_j6BUWLFjN5twr3TOMvZCilEK2r8cSR7ClErIppSpFJR6xndRdXwjdqMdsJ_qmL7So-zN2TjQKITpdi6fsTLVaK6G7Hdt_juH7Eih54Hd2WpGHgZONEA64eMv9wq1bp0T83qcfnMLkHU_rHNZIb_glnzHZwi52OpInbhfH6UgJZ7sVRrzzeP-MPRnsRPj84V6wb--vv159KG4_3Xy8urwtoJYyFftaq6YR0nWqUrVzDsD1sgFrNbRNJZoGZGUtdm6Avq2dyIAaxB6gV32LWF2wV6feQwy_VqRkZk-A02QXDCsZ2XW1bLMsnVF1QiEGooiDOUQ_23g0UpjNrRnN5tZsbo1UJrvNoZcP_et-Rvc38kdmBt6eAMwr8_JoCDwugM5HhGRc8P_vf_dPHCa_eLDTTzwijVl59px3GMoB82X77vbcvGn7rKx-AztRoRE</recordid><startdate>20160401</startdate><enddate>20160401</enddate><creator>Shachar, Shlomit Strulov</creator><creator>Williams, Grant R</creator><creator>Muss, Hyman B</creator><creator>Nishijima, Tomohiro F</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160401</creationdate><title>Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review</title><author>Shachar, Shlomit Strulov ; Williams, Grant R ; Muss, Hyman B ; Nishijima, Tomohiro F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-b4825501d72324dddccd915caa8c653055c13aae7dfc964d0dcc2f0bcc9296ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body Mass Index</topic><topic>Cancer</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Neoplasms - mortality</topic><topic>Prognosis</topic><topic>Prognostic factor</topic><topic>Sarcopenia</topic><topic>Sarcopenia - etiology</topic><topic>Sarcopenia - mortality</topic><topic>Skeletal mass index (SMI)</topic><topic>Solid tumours</topic><topic>Survival</topic><topic>Systematic review</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shachar, Shlomit Strulov</creatorcontrib><creatorcontrib>Williams, Grant R</creatorcontrib><creatorcontrib>Muss, Hyman B</creatorcontrib><creatorcontrib>Nishijima, Tomohiro F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shachar, Shlomit Strulov</au><au>Williams, Grant R</au><au>Muss, Hyman B</au><au>Nishijima, Tomohiro F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2016-04-01</date><risdate>2016</risdate><volume>57</volume><spage>58</spage><epage>67</epage><pages>58-67</pages><issn>0959-8049</issn><eissn>1879-0852</eissn><abstract>Abstract Background Body composition plays an important role in predicting treatment outcomes in adults with cancer. Using existing computed tomographic (CT) cross-sectional imaging and readily available software, the assessment of skeletal muscle mass to evaluate sarcopenia has become simplified. We performed a systematic review and meta-analysis to quantify the prognostic value of skeletal muscle index (SMI) obtained from cross-sectional CT imaging on clinical outcomes in non-haematologic solid tumours. Methods We searched PubMed and the American Society Clinical Oncology online database of meeting abstracts up to October 2015 for relevant studies. We included studies assessing the prognostic impact of pre-treatment SMI on clinical outcomes in patients with non-haematologic solid tumours. The primary outcome was overall survival (OS) and the secondary outcomes included cancer-specific survival (CSS), disease-free survival (DFS), and progression-free survival (PFS). The summary hazard ratio (HR) and 95% confidence interval (CI) were calculated. Results A total of 7843 patients from 38 studies were included. SMI lower than the cut-off was associated with poor OS (HR = 1.44, 95% CI = 1.32–1.56, p  &lt; 0.001). The effect of SMI on OS was observed among various tumour types and across disease stages. Worse CSS was also associated with low SMI (HR = 1.93, 95% CI = 1.38–2.70, p  &lt; 0.001) as well as DFS (HR = 1.16, 95% CI = 1.00–1.30, p  = 0.014), but not PFS (HR = 1.54, 95% CI = 0.90–2.64, p  = 0.117). Conclusions This meta-analysis demonstrates that low SMI at cancer diagnosis is associated with worse survival in patients with solid tumours. Further research into understanding and mitigating the negative effects of sarcopenia in adults with cancer is needed.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26882087</pmid><doi>10.1016/j.ejca.2015.12.030</doi><tpages>10</tpages></addata></record>
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identifier ISSN: 0959-8049
ispartof European journal of cancer (1990), 2016-04, Vol.57, p.58-67
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1879-0852
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subjects Adult
Aged
Aged, 80 and over
Body Mass Index
Cancer
Female
Hematology, Oncology and Palliative Medicine
Humans
Kaplan-Meier Estimate
Male
Meta-analysis
Middle Aged
Neoplasms - mortality
Prognosis
Prognostic factor
Sarcopenia
Sarcopenia - etiology
Sarcopenia - mortality
Skeletal mass index (SMI)
Solid tumours
Survival
Systematic review
Young Adult
title Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review
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