Sarcopenia as a prognostic indicator in colorectal cancer: an updated meta-analysis

Jie He; Wei Luo; Yuanyuan Huang; Lingmeng Song; Yang Mei

doi:10.3389/fonc.2023.1247341

Sarcopenia as a prognostic indicator in colorectal cancer: an updated meta-analysis

Front Oncol. 2023 Oct 27:13:1247341. doi: 10.3389/fonc.2023.1247341. eCollection 2023.

Authors

Jie He^#^{1

2

3}, Wei Luo^#^{1

4}, Yuanyuan Huang^#^{1

2

3}, Lingmeng Song^#^{1

5}, Yang Mei^{1

2

3}

Affiliations

¹ Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.
² Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
³ Key Laboratory of Geriatric Respiratory Diseases of Sichuan Higher Education Institutes, Chengdu, Sichuan, China.
⁴ Radiology Department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
⁵ Medical Department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.

^# Contributed equally.

Abstract

Background: Sarcopenia, often observed in the elderly, is associated with declining skeletal muscle mass and impaired muscle function. This condition has been consistently linked to a less favorable prognosis in various malignancies. Computed tomography (CT) is a frequently employed modality for evaluating skeletal muscle mass, enabling the measurement of the skeletal muscle index (SMI) at the third lumbar vertebra (L3) level. This measurement serves as a defining criterion for sarcopenia. The meta-analysis dealt with evaluating the promise sarcopenia held as a prognostic indicator in individuals with colorectal cancer.

Methods: Research relevant to the subject was determined by systematically searching PubMed, Embase, Web of Science, WANFANG, and CNKI (up to June 11, 2023, published studies). In this meta-analysis, the incidence of sarcopenia in individuals with colorectal cancer was combined to analyze the disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) of these individuals with and without sarcopenia. The included research was evaluated for quality per the Newcastle-Ottawa Scale (NOS) score. In the multivariate analysis of each study, the direct extraction of hazard ratio (HR) with a 95% confidence interval (CI) was executed. STATA 11.0 was applied to integrate and statistically analyze the data.

Results: Overall 20 articles participated in this meta-analysis. A 34% incidence of sarcopenia was noted in colorectal cancer. The presence of sarcopenia denoted a decrease in OS (HR=1.72,95% CI=1.45-2.03), DFS (HR=1.42,95% CI=1.26-1.60) and CSS (HR=1.48,95% CI=1.26-1.75) in individuals with colorectal cancer. In addition, the subgroup analysis depicted a pattern consistent with the overall analysis results.

Conclusion: CT-defined sarcopenia exhibits promise as an indicator of survival prognosis in individuals with colorectal cancer. Future studies need a more rigorous definition of sarcopenia to further verify these findings.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023431435.

Keywords: colorectal cancer; meta-analysis; prognosis; sarcopenia; skeletal muscle mass.

Publication types

Systematic Review

Grants and funding

This work was supported by Sichuan Medical Research Project Foundation (S21054). Priming Scientific Research Foundation for the Introduced Talents of The First Affiliated Hospital of Chengdu Medical College (CYFY-GQ59).