Prevalence of computed tomography-based sarcopenia and the prognostic value of skeletal muscle index and muscle attenuation amongst women with epithelial ovarian malignancy: A systematic review and meta-analysis. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Tranoulis, Anastasios; Kwong, Fong Lien Audrey; Lakhiani, Aarti; Georgiou, Dimitra; Yap, Jason; Balega, Janos
• Is Part Of: European journal of surgical oncology. Volume 48:Issue 7(2022)
• Page Start: 1441
• Page End: 1454
• Publication Date: 2022-07
• Subjects: Sarcopenia -- Skeletal mass index -- Muscle attenuation -- Epithelial ovarian cancer -- Morbidity -- Oncological outcomes -- Meta-analysis; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2022.02.024
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Background: Sarcopenia represents an index of frailty amongst cancer patients and it is associated with poor oncological outcomes and a higher risk of surgical complications in several types of malignancy. Aim: To further delineate the impact of sarcopenia assessed via computed tomography scan (CT) on oncological outcomes and post-operative complications amongst women with epithelial ovarian carcinoma (EOC). Our secondary objective was to quantify and understand the prevalence of sarcopenia in EOC. Design: We systematically searched MEDLINE, SCOPUS, ClinicalTrials.gov, and Cochrane Database, from inception up to August 2021. Quality assessment was performed using the Newcastle-Ottawa scale (NOS). Outcomes consisted of prevalence, overall survival (OS), progression-free survival (PFS) and post-operative complications. Pooled analyses of proportion estimates, hazard ratios (HRs) and odds ratios (ORs) were performed with STATA and Review Manager 5.3. Results: 2 1 studies were included in this meta-analysis. NOS scores ranged from six to nine. Pooled analysis yielded an overall sarcopenia prevalence of 41%. Pooled analysis of adjusted HRs demonstrated significant association between low muscle attenuation (MA) [aHR = 1.23, (95% CI 1.02–1.47), p-value = 0.03] and OS, whilst low skeletal muscle index (SMI) trended towards shorter OS [aHR = 1.37, (95% CI 0.99–1.90), p-value = 0.05. Low-SMI was also associated with higher risk of total post-operative complications [uOR = 1.56, (95% CI 1.16–2.11), p-value = 0.004]. Conclusion: Our findings suggest that CT-assessed skeletal mass and radiodensity represent rather accurate indices of nutritional status and could prospectively be incorporated into the decision-making process in women with EOC.