Background
Methods
Standard protocol approvals
Search strategy and selection criteria
Eligibility criteria
Study selection, data collection, and data extraction
Quality assessment
Statistical analysis
Results
Literature search and study characteristics
First author | Year | Study design | Region | Diagnosed period | Sample size | Female% | Median/mean age | Main Treatment | Original cancer type | Cancer metastases |
Lee, J. H | 2021 | Retrospective cohort study | Korea | 2018 to 2021 | 70 | 0 | 66 | Chemotherapy | Hormone-sensitive prostate cancer | Bone, lung, liver, pleura, adrenal gland, peritoneum, ureter |
Lee, C. H | 2021 | Retrospective cohort study | Korea | 2010 to 2017 | 78 | 24.4 | 61 | Chemotherapy | Renal cell carcinoma | NR |
Haik | 2021 | Retrospective cohort study | France | 2013 to 2017 | 261 | 24 | 61.9 (mean) | Immunity therapy | Head, lung, renal, bladder cancer | Liver, lung, bone, brain |
Gallois | 2021 | Retrospective cohort study | France | 2013 to 2016 | 149 | 67 | NR | Chemotherapy | Colorectal cancer | NR |
Chang | 2021 | Retrospective cohort study | China | 2007 to 2018 | 109 | 42.2 | 60.9 (mean) | Chemotherapy | Gastrointestinal stromal tumor | Liver |
Catanese | 2021 | Retrospective cohort study | Italy | 2010 to 2017 | 78 | 28.2 | 67 | Chemotherapy | Esophago–gastric junction cancer, proximal gastric cancer, distal gastric cancer | Liver, lung, lymph nodes, peritoneum, bone |
Yamazaki | 2020 | Retrospective cohort study | Japan | 2015 to 2019 | 54 | 64.81 | 66.5 | Chemotherapy | Thyroid cancer | Liver, lung, bone, brain, lymph node |
Shimizu | 2020 | Retrospective cohort study | Japan | 2017 to 2019 | 29 | 15 | 73 | Chemotherapy | Bladder tumor, upper tract urothelial carcinoma | Liver, lung, lymph nodes, bone |
Lee, B. M | 2020 | Retrospective cohort study | Korea | 2007 to 2016 | 353 | 42.5 | 67 | Chemotherapy | Gall bladder, intrahepatic bile duct, non-hilar bile duct, perihilar bile duct, ampullary cancer | NR |
da Cunha | 2019 | Retrospective cohort study | Brazil | 2009 to 2015 | 72 | 44.4 | 59.4 (mean) | Surgery and chemotherapy | Colorectal cancer | Peritoneum and other organs |
Franzoi | 2020 | Retrospective cohort study | Belgium | 2016 to 2019 | 50 | 100 | 61.2 (mean) | Chemotherapy | Breast cancer | Visceral disease, bone only or locorregional |
Palleschi | 2022 | Retrospective cohort study | Italy | 2009 to 2020 | 43 | 100 | 58 | Chemotherapy | Breast cancer | NR |
Williet | 2021 | Retrospective cohort study | France | 2012 to 2018 | 79 | 45.6 | 66 | Chemotherapy | Pancreatic cancer | NR |
Ishihara | 2016 | Retrospective cohort study | Japan | 2007 to 2014 | 71 | 29.6 | 64 | Chemotherapy | Renal Cell Carcinoma | NR |
Gu | 2017 | Retrospective cohort study | China | 2008 to 2014 | 101 | 35.6 | 59 | Chemotherapy | Renal cell carcinoma | NR |
Malik | 2021 | Retrospective cohort study | Poland | 2017 to 2020 | 78 | 45 | 64.5 | Chemotherapy | Colorectal cancer | Liver, lung, lymph node, peritoneum |
First author
|
Measurements of sarcopenia
|
Sarcopenia definition
|
Outcomes (HR, 95% CI)
|
median/mean Follow-up period
|
Lee, J. H. | L3-SMI | SMI ≤ 52.4 cm2/m2 | PFS(crude HR, 4.73, 1.40–15.96; adjusted HR, 3.77, 0.95–14.99) | 20.5 months |
Lee, C. H. | L3-SMI | SMI of < 43cm2/m2 and < 53 cm2/m2 for men with a BMI of < 25 kg/m2 and ≥ 25kg/m2, respectively, and < 41 cm2/m2 for women | PFS(crude HR, 3.18, 1.84–5.47; adjusted HR, 2.62, 1.47–4.66) | 15.4 months |
Haik | L3-SMI | < 41 cm2/m2 for females and < 43 cm2/m2 for males if body mass index (BMI) < 25 kg/m2 or < 53 cm2/m2 if BMI ≥ 25 kg/m2 | PFS(adjusted HR, 0.80, 0.60–1.055) | NR |
Gallois | L3-SMI | men < 40.3 cm2/m2 and women < 32.0 cm2/m2 | PFS(crude HR, 1.5, 1.0−2.2) | 23 months |
Chang | L3-PMI | < 6.36 cm2/m2 for males and < 3.92 cm2/m2 for females | PFS(adjusted HR, 2.333, 1.251−4.349) | NR |
Catanese | L3-SMI | male patients asSMI < 43 cm2/m2 if BMI < 25 kg/m2 and SMI < 53 cm2/m2 if BMI ≥ 25 kg/m2, and infemale patients as SMI < 41 cm2/m2 irrespective of BMI | PFS(crude HR, 0.83, 0.53–1.32) | 52.2 months |
Yamazaki | L3-SMI | < 42 cm2/m2 for males and < 38 cm2/m2 for females | PFS(adjusted HR, 2.488, 1.058–5.846) | NR |
Shimizu | L3-PMI | ≤ 6.36 cm2/m2 for men and ≤ 3.92 cm2/m2 for women | PFS(crude HR, 2.99, 1.14–7.85; adjusted HR, 2.79, 1.14–7.32) | 7 months |
Lee, B. M. | L3-SMI | < 55 cm2/m2 for male and < 39 cm2/m2 for female | PFS(crude HR, 0.75, 0.61–0.93) | 7.77 months |
da Cunha | L3-SMI | SMI < 41 cm2/m2 for women; SMI < 43 cm2/m2 if BMI < 25 kg/m2 and SMI < 53 cm2/m2 if BMI ≤ 25 kg/m2 for men | PFS(crude HR, 2.34, 1.40–3.93; adjusted HR, 1.78, 1.00–3.14) | 23.6 months |
Franzoi | L3-SMI | SMI < 40 cm2/m2 | PFS(crude HR, 2.52, 1.02–6.19) | 14.4 months |
Palleschi | L3-SMI | SMI < 40 cm2/m2 | PFS(crude HR, 0.98, 0.47–2.03) | 33 months |
Williet | TPI | < 5.73 cm2/m2 for men and < 4.37 cm2/m2 for women | PFS(crude HR, 2.3, 1.38–3.85; adjusted HR, 2.04, 1.18–3.53) | NR |
Ishihara | L3-SMI | men with a BMI of < 25 kg/m2 and SMI < 43 cm2/m2; men with a BMI of > 25 kg/m2 and SMI < 53 cm2/m2; women with SMI < 41 cm2/m2 | PFS(crude HR, 3.15, 1.66–6.41; adjusted HR, 2.54, 1.19–5.65) | 20.2 months (mean) |
Gu | L3-SMI | < 40.8 cm2/m2 for males and < 34.9 cm2/m2 for females | PFS(crude HR, 1.426, 0.880–2.310) | NR |
Malik | L3-SMI | < 52.4 cm2/m2 for men and < 38.5 cm2/m2 for women | PFS(adjusted HR, 1.47, 0.88–2.5) | 19.1 months |
Methodological quality (risk of bias)
Author | Year | Study Design | Selection | Comparability | Exposure/Outcome | Total Score | Risk of Bias | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Representativeness of cohort *
|
Selection of control cohort *
|
Ascertainment of exposure *
|
Outcome not present at start *
|
Comparability of cohorts **
|
Assessment of outcome *
|
Length of follow-up *
|
Adequacy of follow-up *
|
Total score
| ||||
Lee, J. H | 2021 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Lee, C. H | 2021 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Haik | 2021 | Retrospective cohort study | * | * | * | ** | * | 6 | High | |||
Gallois | 2021 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Chang | 2021 | Retrospective cohort study | * | * | * | ** | * | 6 | High | |||
Catanese | 2021 | Retrospective cohort study | * | * | * | ** | * | * | 7 | Low | ||
Yamazaki | 2020 | Retrospective cohort study | * | * | * | ** | * | 6 | High | |||
Shimizu | 2020 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Lee, B. M | 2020 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
da Cunha | 2019 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Franzoi | 2020 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Palleschi | 2022 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Williet | 2021 | Retrospective cohort study | * | * | * | ** | * | 6 | High | |||
Ishihara | 2016 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low | |
Gu | 2017 | Retrospective cohort study | * | * | * | ** | * | 6 | High | |||
Malik | 2021 | Retrospective cohort study | * | * | * | ** | * | * | * | 8 | Low |
Associations between sarcopenia and the risk of poor PFS
Subgroup analysis
Variables
|
HR
|
95% CI
| I2 (%) |
No. studies
|
P
for interaction
| |
---|---|---|---|---|---|---|
Regions
| < 0.001 | |||||
Asia | 1.98 | 1.18 to 3.31 | 83.6 | 8 | ||
Europe | 1.25 | 0.91 to 1.73 | 66.9 | 7 | ||
Gender
| < 0.001 | |||||
Female ≤ 50% | 1.53 | 1.12 to 2.11 | 79.8 | 12 | ||
Female > 50% | 1.61 | 1.11 to 2.33 | 21.4 | 4 | ||
Original cancer type
| < 0.001 | |||||
Gastrointestinal | 1.28 | 0.87 to 1.89 | 79.9 | 6 | ||
Urologic | 1.57 | 1.02 to 2.41 | 7.3 | 5 | ||
Endocrine Gland | 2.16 | 1.36 to 3.43 | 0 | 2 | ||
Breast | 1.51 | 0.60 to 3.80 | 0 | 2 | ||
Quality assessment
| < 0.001 | |||||
Low risk of bias | 1.56 | 1.10 to 2.21 | 77.1 | 11 | ||
High risk of bias | 1.59 | 0.96 to 2.62 | 79.2 | 5 | ||
Type of HR | < 0.001 | |||||
Univariate | 0.84 | 0.70 to 0.98 | 50.9 | 6 | ||
Multivariate | 1.01 | 0.81 to 1.22 | 57.8 | 10 |
Sensitivity analyses and publication bias
Cancer type | HR | 95% CI | I2 (%) | No. studies |
---|---|---|---|---|
Colorectal | 1.55 | 1.18 to 2.04 | 0 | 3 |
Gastric | 1.36 | 0.49 to 3.74 | 85.5 | 2 |