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Effect of sarcopenia on clinical outcomes following digestive carcinoma surgery: a meta-analysis

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Abstract

Background

The effect of sarcopenia on digestive carcinoma surgery outcomes is controversial. We aimed to assess the effect of sarcopenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP) or the Asian Working Group for Sarcopenia (AWGS) on outcomes following digestive carcinoma surgery.

Methods

Eligible studies were searched from PubMed, EMBASE and other databases from inception to April 2018. We conducted a meta-analysis to estimate the risk ratios or mean differences of outcomes in the sarcopenia group versus the non-sarcopenia group. Stratified analyses and sensitivity analyses were performed.

Results

We included 11 cohort studies, with a sarcopenia prevalence ranging from 11.6 to 33.0%. Sarcopenia was associated with an increased risk of total complications (RR = 1.87, P < 0.00001), major complications (RR = 2.45, P = 0.002), re-admissions (RR = 2.53,P < 0.0001), infections (RR = 2.23, P = 0.09), severe infections (RR = 2.96, P = 0.04), 30-day mortality (RR = 3.36, P = 0.001), longer hospital stay (MD = 4.61, P = 0.001) and increased hospitalization expenditures (SMD = 0.25, P = 0.02). Sarcopenia differentially affected outcomes when stratified, and the results were stable.

Conclusions

Sarcopenia defined by the EWGSOP or AWGS Consensus was a high-risk factor for digestive carcinoma surgery outcomes. Different tumour site and muscle mass measurements are the sources of heterogeneity. More high-quality studies are needed.

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Funding

This work was funded by the Postgraduate Research & Practice Innovation Program of Jiangsu Province awarded to Xu Xinyi.

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Author notes

  1. Hongxia Hua and Xinyi Xu contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Nanjing Medical University, Nanjing, 211166, China

    Hongxia Hua, Xinyi Xu, Ziqi Ren & Qin Xu

  2. Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 211166, China

    Yu Tang

  3. Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 211166, China

    Li Chen

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  1. Hongxia Hua
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Correspondence to Qin Xu.

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Hua, H., Xu, X., Tang, Y. et al. Effect of sarcopenia on clinical outcomes following digestive carcinoma surgery: a meta-analysis. Support Care Cancer 27, 2385–2394 (2019). https://doi.org/10.1007/s00520-019-04767-4

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