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Preoperative computed tomography-assessed sarcopenia as a predictor of complications and long-term prognosis in patients with colorectal cancer: a systematic review and meta-analysis

  • Systematic Reviews and Meta-analyses
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Abstract

Background

The relationship between computed tomography (CT)-assessed sarcopenia and colorectal cancer (CRC) prognosis varies in different studies. This systematic review aimed to examine the impact of preoperative CT-assessed sarcopenia on complications and long-term survival in CRC patients.

Methods

The PubMed, Web of Science, Cochrane Library, and Embase databases were searched for relevant literature up to September 10, 2020. Data and characteristics for each study were extracted. Long-term outcomes were assessed using a comprehensive HR with a 95% CI. Complications were assessed using a comprehensive OR with 95% CI. The heterogeneity and publication bias were also investigated, and subgroup and sensitivity analyses were performed.

Results

A total of 19 studies comprising 15,889 patients were included. The comprehensive results demonstrated that sarcopenia is significantly associated with overall survival of CRC patients (HR = 1.40, 95% CI = 1.25–1.58, p < 0.001). Patients with sarcopenia have a higher risk of complications compared to those without sarcopenia. In addition, sarcopenia is strongly associated with poor cancer-specific survival (HR = 1.49, 95% CI = 1.32–1.68, p < 0.001) and disease-free survival (HR = 1.59, 95% CI = 1.32–1.92, p < 0.001) in CRC patients. There is no significant relationship between sarcopenia and recurrence-free survival (HR = 1.32, 95% CI = 0.92–1.89, p = 0.126).

Conclusions

Preoperative CT-assessed sarcopenia can be employed as an effective predictor of complications and long-term prognosis in CRC patients. Standardization of CT-assessed sarcopenia requires comprehensive consideration of race, muscle mass index, body mass index, and gender.

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Data availability

All datasets presented in this study are included in the article.

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Author notes

  1. Hailun Xie and Lishuang Wei have contributed equally to this paper.

Authors and Affiliations

  1. Department of Colorectal and Anal Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China

    Hailun Xie, Mingxiang Liu, Guanghui Yuan & Jialiang Gan

  2. Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China

    Lishuang Wei

  3. Department of Pharmacy, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China

    Shuangyi Tang

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  1. Hailun Xie
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Contributions

J.L.G., S.Y.T., H.L.X., and L.S.W. designed this research; M.X.L., G.H.Y., and S.Y.T. performed the statistical analysis; H.L.X. and L.S.W. performed the data extraction, and drafted and revised the manuscript. All authors reviewed and approved the final manuscript.

Corresponding authors

Correspondence to Shuangyi Tang or Jialiang Gan.

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This article did not contain any studies with human participants or animals performed by any of the authors.

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Considering the nature of this study, informed consent was not required.

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The protocol was registered at PROSPERO: CRD42020216306.

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Xie, H., Wei, L., Liu, M. et al. Preoperative computed tomography-assessed sarcopenia as a predictor of complications and long-term prognosis in patients with colorectal cancer: a systematic review and meta-analysis. Langenbecks Arch Surg 406, 1775–1788 (2021). https://doi.org/10.1007/s00423-021-02274-x

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