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The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review
GI tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the...
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Published in: | Clinical nutrition ESPEN 2022-02, Vol.47, p.135-146 |
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description | GI tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the role of sarcopenic obesity (SO) in patients with GI tumors remains controversial. We systematically reviewed data on the prevalence and prognostic impact of SO for patients with GI malignancies, undergoing surgical and/or chemotherapeutical treatment.
This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library were searched for relevant original studies published between January 2008 to December 2020 reporting postoperative morbidity and mortality, long-term survival and toxicity after chemotherapeutical treatment in SO patients with GI cancer.
Twenty-two studies comprising 8571 patients were included. The percentage of SO patients ranged from 2.6% to 51%. The association between SO and outcomes of interest was inconsistent because of various cut-offs used to define sarcopenia and obesity. However, SO was significantly associated with the occurrence of major postoperative complications in five studies. In contrast, three studies did not show the impact of SO on postoperative complications. Three studies demonstrated that mortality rate was significantly higher among patients with SO. Five studies of systematic review revealed a statistically significant influence of SO on overall survival in multivariate analysis. However, only in one of them a significant difference was found between SO and DFS. Three studies evaluated toxicity after chemotherapy and all reported statistically significant negative impact of SO.
There is considerable heterogeneity in methods used to define SO in the literature and current data is limited. Standardized terminology and deeper understanding of sarcopenic obesity pathophysiology is needed to further understand the influence of obesity and sarcopenia on the clinical trajectory of patients with GI cancer. |
doi_str_mv | 10.1016/j.clnesp.2021.11.004 |
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This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library were searched for relevant original studies published between January 2008 to December 2020 reporting postoperative morbidity and mortality, long-term survival and toxicity after chemotherapeutical treatment in SO patients with GI cancer.
Twenty-two studies comprising 8571 patients were included. The percentage of SO patients ranged from 2.6% to 51%. The association between SO and outcomes of interest was inconsistent because of various cut-offs used to define sarcopenia and obesity. However, SO was significantly associated with the occurrence of major postoperative complications in five studies. In contrast, three studies did not show the impact of SO on postoperative complications. Three studies demonstrated that mortality rate was significantly higher among patients with SO. Five studies of systematic review revealed a statistically significant influence of SO on overall survival in multivariate analysis. However, only in one of them a significant difference was found between SO and DFS. Three studies evaluated toxicity after chemotherapy and all reported statistically significant negative impact of SO.
There is considerable heterogeneity in methods used to define SO in the literature and current data is limited. Standardized terminology and deeper understanding of sarcopenic obesity pathophysiology is needed to further understand the influence of obesity and sarcopenia on the clinical trajectory of patients with GI cancer.</description><identifier>ISSN: 2405-4577</identifier><identifier>EISSN: 2405-4577</identifier><identifier>DOI: 10.1016/j.clnesp.2021.11.004</identifier><identifier>PMID: 35063193</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Body Composition ; Gastrointestinal cancer ; Gastrointestinal Neoplasms - complications ; Humans ; Obesity - complications ; Obesity - epidemiology ; Postoperative outcomes ; Sarcopenia - complications ; Sarcopenia - epidemiology ; Sarcopenic obesity ; Survival ; Toxicity ; Treatment Outcome</subject><ispartof>Clinical nutrition ESPEN, 2022-02, Vol.47, p.135-146</ispartof><rights>2021 European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-8143c7525360b45ce1b6f9fb350c569c3ea8da3e4cf41bfa0b9a47827a480a9a3</citedby><cites>FETCH-LOGICAL-c362t-8143c7525360b45ce1b6f9fb350c569c3ea8da3e4cf41bfa0b9a47827a480a9a3</cites><orcidid>0000-0003-4174-6637 ; 0000-0001-5516-7367 ; 0000-0002-7281-3591 ; 0000-0002-7748-8273</orcidid></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/35063193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dikova, Tatyana Sergeevna</creatorcontrib><creatorcontrib>Zatsepina, Alina Yurievna</creatorcontrib><creatorcontrib>Fedorinov, Denis Sergeevich</creatorcontrib><creatorcontrib>Lyadov, Vladimir Konstantinovich</creatorcontrib><title>The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review</title><title>Clinical nutrition ESPEN</title><addtitle>Clin Nutr ESPEN</addtitle><description>GI tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the role of sarcopenic obesity (SO) in patients with GI tumors remains controversial. We systematically reviewed data on the prevalence and prognostic impact of SO for patients with GI malignancies, undergoing surgical and/or chemotherapeutical treatment.
This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library were searched for relevant original studies published between January 2008 to December 2020 reporting postoperative morbidity and mortality, long-term survival and toxicity after chemotherapeutical treatment in SO patients with GI cancer.
Twenty-two studies comprising 8571 patients were included. The percentage of SO patients ranged from 2.6% to 51%. The association between SO and outcomes of interest was inconsistent because of various cut-offs used to define sarcopenia and obesity. However, SO was significantly associated with the occurrence of major postoperative complications in five studies. In contrast, three studies did not show the impact of SO on postoperative complications. Three studies demonstrated that mortality rate was significantly higher among patients with SO. Five studies of systematic review revealed a statistically significant influence of SO on overall survival in multivariate analysis. However, only in one of them a significant difference was found between SO and DFS. Three studies evaluated toxicity after chemotherapy and all reported statistically significant negative impact of SO.
There is considerable heterogeneity in methods used to define SO in the literature and current data is limited. Standardized terminology and deeper understanding of sarcopenic obesity pathophysiology is needed to further understand the influence of obesity and sarcopenia on the clinical trajectory of patients with GI cancer.</description><subject>Body Composition</subject><subject>Gastrointestinal cancer</subject><subject>Gastrointestinal Neoplasms - complications</subject><subject>Humans</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Postoperative outcomes</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - epidemiology</subject><subject>Sarcopenic obesity</subject><subject>Survival</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><issn>2405-4577</issn><issn>2405-4577</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOHDEQRa0oKCCYP0CRl9lM41e_soiEUAJISGyGtVVdU5141G13bE-i-XuMhqCsWFUtzq3HYexSikoK2VztKpw8paVSQslKykoI84GdKSPqtanb9uN__SlbpbQTouT63kjxiZ3qWjRa9vqMjZtfxN28AGYeRp4gYljIO-RhoOTygQfPcyTIM_mC7DOGmRJ3nv-ElGNwPlPKzsPEETxS_MqveTqkTDPkMibSH0d_L9jJCFOi1Ws9Z08_vm9u7tYPj7f3N9cPa9SNyutOGo1trWrdiMHUSHJoxn4cyr1YNz1qgm4LmgyORg4jiKEH03aqBdMJ6EGfsy_HuUsMv_flMDu7hDRN4Cnsk1WNUqpTSjYFNUcUY0gp0miX6GaIByuFfZFsd_Yo2b5ItlLaIrnEPr9u2A8zbd9C_5QW4NsRoPJn-T3ahI6Kma2LhNlug3t_wzMqCZC7</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Dikova, Tatyana Sergeevna</creator><creator>Zatsepina, Alina Yurievna</creator><creator>Fedorinov, Denis Sergeevich</creator><creator>Lyadov, Vladimir Konstantinovich</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><orcidid>https://orcid.org/0000-0003-4174-6637</orcidid><orcidid>https://orcid.org/0000-0001-5516-7367</orcidid><orcidid>https://orcid.org/0000-0002-7281-3591</orcidid><orcidid>https://orcid.org/0000-0002-7748-8273</orcidid></search><sort><creationdate>202202</creationdate><title>The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review</title><author>Dikova, Tatyana Sergeevna ; Zatsepina, Alina Yurievna ; Fedorinov, Denis Sergeevich ; Lyadov, Vladimir Konstantinovich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-8143c7525360b45ce1b6f9fb350c569c3ea8da3e4cf41bfa0b9a47827a480a9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Body Composition</topic><topic>Gastrointestinal cancer</topic><topic>Gastrointestinal Neoplasms - complications</topic><topic>Humans</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Postoperative outcomes</topic><topic>Sarcopenia - complications</topic><topic>Sarcopenia - epidemiology</topic><topic>Sarcopenic obesity</topic><topic>Survival</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dikova, Tatyana Sergeevna</creatorcontrib><creatorcontrib>Zatsepina, Alina Yurievna</creatorcontrib><creatorcontrib>Fedorinov, Denis Sergeevich</creatorcontrib><creatorcontrib>Lyadov, Vladimir Konstantinovich</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>Clinical nutrition ESPEN</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dikova, Tatyana Sergeevna</au><au>Zatsepina, Alina Yurievna</au><au>Fedorinov, Denis Sergeevich</au><au>Lyadov, Vladimir Konstantinovich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review</atitle><jtitle>Clinical nutrition ESPEN</jtitle><addtitle>Clin Nutr ESPEN</addtitle><date>2022-02</date><risdate>2022</risdate><volume>47</volume><spage>135</spage><epage>146</epage><pages>135-146</pages><issn>2405-4577</issn><eissn>2405-4577</eissn><abstract>GI tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the role of sarcopenic obesity (SO) in patients with GI tumors remains controversial. We systematically reviewed data on the prevalence and prognostic impact of SO for patients with GI malignancies, undergoing surgical and/or chemotherapeutical treatment.
This study was conducted in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library were searched for relevant original studies published between January 2008 to December 2020 reporting postoperative morbidity and mortality, long-term survival and toxicity after chemotherapeutical treatment in SO patients with GI cancer.
Twenty-two studies comprising 8571 patients were included. The percentage of SO patients ranged from 2.6% to 51%. The association between SO and outcomes of interest was inconsistent because of various cut-offs used to define sarcopenia and obesity. However, SO was significantly associated with the occurrence of major postoperative complications in five studies. In contrast, three studies did not show the impact of SO on postoperative complications. Three studies demonstrated that mortality rate was significantly higher among patients with SO. Five studies of systematic review revealed a statistically significant influence of SO on overall survival in multivariate analysis. However, only in one of them a significant difference was found between SO and DFS. Three studies evaluated toxicity after chemotherapy and all reported statistically significant negative impact of SO.
There is considerable heterogeneity in methods used to define SO in the literature and current data is limited. Standardized terminology and deeper understanding of sarcopenic obesity pathophysiology is needed to further understand the influence of obesity and sarcopenia on the clinical trajectory of patients with GI cancer.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>35063193</pmid><doi>10.1016/j.clnesp.2021.11.004</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4174-6637</orcidid><orcidid>https://orcid.org/0000-0001-5516-7367</orcidid><orcidid>https://orcid.org/0000-0002-7281-3591</orcidid><orcidid>https://orcid.org/0000-0002-7748-8273</orcidid></addata></record> |
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subjects | Body Composition Gastrointestinal cancer Gastrointestinal Neoplasms - complications Humans Obesity - complications Obesity - epidemiology Postoperative outcomes Sarcopenia - complications Sarcopenia - epidemiology Sarcopenic obesity Survival Toxicity Treatment Outcome |
title | The impact of sarcopenic obesity on treatment outcomes in gastrointestinal cancer: A systematic review |
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