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Clin Nutr. 2018 Aug;37(4):1101-1113. doi: 10.1016/j.clnu.2017.07.010. Epub 2017 Jul 13.

Prevalence and predictive value of pre-therapeutic sarcopenia in cancer patients: A systematic review.

Author information

1
APHP, Avicenne Hospital, Geriatric Department, Coordination Unit in Geriatric Oncology, F-93000, Bobigny, France; Université Paris 13, Sorbonne Paris Cité, Health Education and Practices Laboratory (LEPS EA3412), F-93017, Bobigny, France. Electronic address: frederic.pamoukdjian@aphp.fr.
2
APHP, Avicenne Hospital, Department of Medical Oncology, F-93000, Bobigny, France.
3
APHP, Avicenne Hospital, Clinical Research Unit/Clinical Research Center, F-93000, Bobigny, France.
4
APHP, Avicenne Hospital, Department of Radiology, F-93000, Bobigny, France.
5
APHP, Henri-Mondor Hospital, Geriatric Department, Geriatric Oncology Unit, F-94000, Créteil, France; Université Paris-Est, UPEC, DHU A-TVB, IMRB- EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), F-94000, Créteil, France.

Abstract

BACKGROUND & AIMS:

To assess the prevalence of sarcopenia before cancer treatment and its predictive value during the treatment.

METHODS:

We searched MEDLINE via PubMed for articles published from 2008 to 2016 that reported prospective observational or interventional studies of the prevalence of pre-therapeutic sarcopenia and its consequences in adults with cancer who were 18 years or older. Two independent reviewers selected articles based on titles and/or abstracts before a complete review. Sarcopenia had to be measured before cancer treatment. Methods recommended by consensuses (CT scan, MRI, dual X-ray absorptiometry or bio-impedancemetry) to assess sarcopenia were considered. Characteristics of the studies included the prevalence of pre-therapeutic sarcopenia and the prognostic value for outcomes during the cancer treatment.

RESULTS:

We selected 35 articles involving 6894 participants (in/out patients, clinical trials). The mean age ranged from 53 to 69.6 years. Pre-therapeutic sarcopenia was found in 38.6% of patients [95% CI 37.4-39.8]. Oesophageal and small-cell lung cancers showed the highest prevalence of pre-therapeutic sarcopenia. Pre-therapeutic sarcopenia was significantly and independently associated with post-operative complications, chemotherapy-induced toxicity and poor survival in cancer patients.

CONCLUSIONS:

Pre-therapeutic sarcopenia is highly prevalent in cancer patients and has severe consequences for outcomes of cancer patients.

KEYWORDS:

Cancer; Chemotherapy; Post-operative complications; Sarcopenia; Survival; Toxicity

PMID:
28734552
DOI:
10.1016/j.clnu.2017.07.010

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