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CT-assessed sarcopenia is a predictive factor for both long-term and short-term outcomes in gastrointestinal oncology patients: a systematic review and meta-analysis.
Su, Huaiying; Ruan, Junxian; Chen, Tianfeng; Lin, Enyi; Shi, Lijing.
Afiliación
  • Su H; Department of Radiology, Quanzhou First Hospital Fujian, Quanzhou, Fujian Province, People's Republic of China.
  • Ruan J; Department of Ultrasonic, Quanzhou Women's and Children's Hospital, 700 Fengze Road, Quanzhou, 362000, Fujian Province, People's Republic of China. junxian_ruan@163.com.
  • Chen T; Department of Radiology, Quanzhou Women's and Children's Hospital, Quanzhou, Fujian Province, People's Republic of China.
  • Lin E; Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, People's Republic of China.
  • Shi L; Department of Ultrasonic, Quanzhou Women's and Children's Hospital, 700 Fengze Road, Quanzhou, 362000, Fujian Province, People's Republic of China.
Cancer Imaging ; 19(1): 82, 2019 Dec 03.
Article en En | MEDLINE | ID: mdl-31796090
ABSTRACT

BACKGROUND:

The impact of sarcopenia on the outcome of gastrointestinal (GI) oncological patients is still controversial. We aim to discuss the prevalence of sarcopenia and its relation to the oncological outcome.

METHODS:

Embase, Medline, PubMed, and the Cochrane library were systematically searched for related keywords. Studies using CT to assess sarcopenia and evaluate its relationship with the outcome of GI oncological patients were included. Long-term outcomes, including overall survival and disease-free survival, were compared by hazard ratios (HRs) with 95% confidence intervals (CIs). Short-term outcomes, including total complications and major complications (Clavien-Dindo ≥IIIa) after curable surgery, were compared by the risk ratio (RR) and 95% CI.

RESULTS:

A total of 70 studies including 21,875 patients were included in our study. The median incidence of sarcopenia was 34.7% (range from 2.1 to 83.3%). A total of 88.4% of studies used skeletal muscle index (SMI) in the third lumbar level on CT to define sarcopenia, and a total of 19 cut-offs were used to define sarcopenia. An increasing trend was found in the prevalence of sarcopenia when the cut-off of SMI increased (ß = 0.22, 95% CI = 0.12-0.33, p < 0.001). The preoperative incidence of sarcopenia was associated both with an increased risk of overall mortality (HR = 1.602, 95% CI = 1.369-1.873, P < 0.001) and with disease-free mortality (HR = 1.461, 95% CI = 1.297-1.646, P < 0.001). Moreover, preoperative sarcopenia was a risk factor for both total complications (RR = 1.188, 95% CI = 1.083-1.303, P < 0.001) and major complications (RR = 1.228, 95% CI = 1.042-1.448, P = 0.014).

CONCLUSION:

The prevalence of sarcopenia depends mostly on the diagnostic cut-off points of different criteria. Preoperative sarcopenia is a risk factor for both long-term and short-term outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tomografía Computarizada por Rayos X / Sarcopenia / Neoplasias Gastrointestinales Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Cancer Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM / NEOPLASIAS Año: 2019 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tomografía Computarizada por Rayos X / Sarcopenia / Neoplasias Gastrointestinales Tipo de estudio: Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Cancer Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM / NEOPLASIAS Año: 2019 Tipo del documento: Article