Chest
Original Research: Lung Cancer
Prognostic Value of Sarcopenia in Lung Cancer: A Systematic Review and Meta-analysis
Section snippets
Methods
During the process of conducting this review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)21 guidelines.
Study Selection and Characteristics
We identified 883 papers (after the removal of duplicates), of which 758 were excluded after screening the titles and abstracts, leaving 25 studies for full review. After reading the full text, another 12 studies were excluded. The reasons for the exclusions are presented in e-Table 3. As a result, we included 13 studies11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 27, 28, 29 with a total of 1,810 participants. Figure 1 presents the PRISMA diagram for the study selection.
Table 1 presents the
Discussion
Our review found that the pooled prevalence of sarcopenia was 43% in NSCLC and 52% in SCLC. The pooled data demonstrated that sarcopenia was independently associated with shorter OS in both NSCLC and SCLC; however, sarcopenia did not appear to be associated with DFS. The association between sarcopenia and PFS appeared to be inconsistent in both NSCLC and SCLC according to two small studies.12, 18 Limited evidence implied that sarcopenia might not have an association with cancer progression,
Conclusion
Sarcopenia is highly prevalent in patients with lung cancer (approximately 1 in 2). Sarcopenia is an important predictor of impaired OS in patients with SCLC or with different stages of NSCLC, but it appears not to be a predictor of DFS in patients with NSCLC. More prospective studies are needed to explore the association between sarcopenia and PFS, treatment-related toxicity, functional impairments, and quality of life in patients with different types of lung cancer.
Acknowledgments
Author contributions: M. Y. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis, including and especially any adverse effects. M. Y., Y. S., L. T., and W. L. contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript.
Financial/nonfinancial disclosures: None declared.
Role of sponsors: The sponsor had no role in the study design, execution, or the
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Summary comments
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FUNDING/SUPPORT: This review was supported by the Health and Family Planning Commission of Sichuan Province (No. ZH2018-102) and Post-Doctor Research Project, West China Hospital, Sichuan University (No. 18HXBH071).