Pre-Therapeutic Sarcopenia among Cancer Patients: An Up-to-Date Meta-Analysis of Prevalence and Predictive Value during Cancer Treatment

• Published in: Nutrients 2023-02, Vol.15 (5), p.1193
• Main Authors: Couderc, Anne-Laure, Liuu, Evelyne, Boudou-Rouquette, Pascaline, Poisson, Johanne, Frelaut, Maxime, Montégut, Coline, Mebarki, Soraya, Geiss, Romain, Ap Thomas, Zoé, Noret, Aurélien, Pierro, Monica, Baldini, Capucine, Paillaud, Elena, Pamoukdjian, Frédéric
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Aged; Aged, 80 and over; Algorithms; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Clinical trials; Complications; Complications and side effects; Computed tomography; Gait; Heterogeneity; Humans; Life Sciences; Meta-analysis; Middle Aged; Muscle Strength; Muscles; Musculoskeletal system; Neoplasms - complications; Nosocomial infection; Nosocomial infections; Patient outcomes; Patients; Postoperative; Prevalence; Prognosis; Progression-Free Survival; Risk assessment; Sarcopenia; Sarcopenia - etiology; Survival; Systematic Review; Toxicity; Working groups
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15051193

This study will address the prevalence of pre-therapeutic sarcopenia (PS) and its clinical impact during cancer treatment among adult cancer patients ≥ 18 years of age. A meta-analysis (MA) with random-effect models was performed via a MEDLINE systematic review, according to the PRISMA statement, focusing on articles published before February 2022 that reported observational studies and clinical trials on the prevalence of PS and the following outcomes: overall survival (OS), progression-free survival (PFS), post-operative complications (POC), toxicities (TOX), and nosocomial infections (NI). A total of 65,936 patients (mean age: 45.7-85 y) with various cancer sites and extensions and various treatment modes were included. Mainly defined by CT scan-based loss of muscle mass only, the pooled prevalence of PS was 38.0%. The pooled relative risks were 1.97, 1.76, 2.70, 1.47, and 1.76 for OS, PFS, POC, TOX, and NI, respectively (moderate-to-high heterogeneity, I : 58-85%). Consensus-based algorithm definitions of sarcopenia, integrating low muscle mass and low levels of muscular strength and/or physical performance, lowered the prevalence (22%) and heterogeneity (I < 50%). They also increased the predictive values with RRs ranging from 2.31 (OS) to 3.52 (POC). PS among cancer patients is prevalent and strongly associated with poor outcomes during cancer treatment, especially when considering a consensus-based algorithm approach.