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Can sarcopenia be a predictor of prognosis for patients with non-metastatic colorectal cancer? A systematic review and meta-analysis

International Journal of Colorectal Disease volume 33, pages 1419–1427 (2018)Cite this article

Abstract

Purpose

We aimed to explore whether sarcopenia diagnosed with the third lumbar vertebra skeletal muscle index (L3 SMI) can be a predictor of prognosis for colorectal cancer (CRC) patients.

Methods

A systematic review and meta-analysis was conducted using PubMed, Embase, and the Web of Science databases. All original comparative studies published in English that were related to sarcopenia versus non-sarcopenia in non-metastatic CRC patients based on postoperative and survival outcomes were included. Data synthesis and statistical analysis were carried out using Stata software.

Results

A total of 12 studies including 5337 patients were included in our meta-analysis. In our overall analyses of postoperative outcomes, we indicated that CRC patients with sarcopenia would have longer hospital stays, higher incidence of total postoperative morbidity (OR = 1.70, 95% CI = 1.07–2.70, P < 0.01), mortality (OR = 3.45, 95% CI = 1.69–7.02, P < 0.01), and infection (OR = 2.21, 95% CI = 1.50–3.25, P < 0.01) but not anastomosis leakage or intestinal obstruction when compared to non-sarcopenia patients. Regarding survival outcomes, our results showed that sarcopenia predicted a decreased overall survival (HR = 1.63, 95% CI = 1.24–2.14, P < 0.01), disease-free survival, and cancer-specific survival for non-metastatic CRC patients. Moreover, our subgroup analyses showed similar tendency with our overall analyzed results.

Conclusions

Sarcopenia diagnosed with L3 SMI can be a negative predictor of postoperative and survival outcomes for non-metastatic CRC patients. Prospective studies with a uniform definition of sarcopenia are needed to update our findings.

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Authors and Affiliations

  1. Department of Anorectal Surgery, the First Hospital of China Medical University, Shenyang, 110001, People’s Republic of China

    Guangwei Sun, Yalun Li, Yangjie Peng, Dapeng Lu, Fuqiang Zhang, Xueyang Cui, Qingyue Zhang & Zhuang Li

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  1. Guangwei Sun
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Sun, G., Li, Y., Peng, Y. et al. Can sarcopenia be a predictor of prognosis for patients with non-metastatic colorectal cancer? A systematic review and meta-analysis. Int J Colorectal Dis 33, 1419–1427 (2018). https://doi.org/10.1007/s00384-018-3128-1

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Keywords

  • Sarcopenia
  • Colorectal cancer
  • Skeletal muscle mass
  • Meta-analysis