Abstract
BackgroundThe impact of sarcopenia on outcomes following treatment for primary liver tumors remains contentious. Therefore, we performed a systematic literature review and meta-analysis to evaluate the clinical significance of sarcopenia in the treatment of patients with primary liver tumors.Data sourcesA systematic literature search was performed in English through February 1, 2017 in databases.ResultsThere were significant differences between patients with and without sarcopenia in overall 1- and 3-year survival (1 year: OR: 0.43; 95% CI: 0.27-0.68; P=0.0004; 3 year: OR: 0.67; 95% CI: 0.47-0.96; P=0.03). However, overall 5-year survival showed no significant difference between the groups (OR: 0.61; 95% CI: 0.35-1.07; P=0.08). Patients with sarcopenia showed a significant 53% reduction in disease-free survival within 5 years (OR: 0.47; 95% CI: 0.28-0.79; P=0.005). Also, sarcopenia had a significantly negative impact on recurrence in patients with primary liver tumors (RR: 2.71; 95% CI: 1.46-5.05; P=0.002). Regarding complications rate, we concluded that there was a statistically significant difference between two groups in overall complications rate (RR: 2.52; 95% CI: 1.50-4.22; P=0.0005). However, the major complications rate showed no significant difference between the groups (RR: 1.19; 95% CI: 0.65-2.20; P=0.57).ConclusionsSarcopenia seemed to have a negative effect on overall survival in patients with primary liver tumors in the early phase post-treatment, but further research is needed to investigate the prognostic impact on overall survival over the longer term. Moreover, sarcopenia could significantly increase the incidence rates of post-treatment recurrence and overall complications in patients with primary liver tumors.
Highlights
Sarcopenia, which is defined as the loss of muscle mass and function [1], is critically involved in aging and in a variety of chronic diseases, such as tuberculosis infection, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), advanced organ failure and other wasting conditions
The major complications rate showed no significant difference between the groups (RR: 1.19; 95% confidence intervals (95% CIs): 0.65-2.20; P=0.57)
Sarcopenia seemed to have a negative effect on overall survival in patients with primary liver tumors in the early phase post-treatment, but further research is needed to investigate the prognostic impact on overall survival over the longer term
Summary
Sarcopenia, which is defined as the loss of muscle mass and function [1], is critically involved in aging and in a variety of chronic diseases, such as tuberculosis infection, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), advanced organ failure and other wasting conditions. To the best of our knowledge, several reviews [15,16,17] have shown that sarcopenia can be associated with impaired overall survival and increased postoperative morbidity in primary liver tumors. We performed a systematic literature review and meta-analysis to evaluate the clinical significance of sarcopenia in the treatment of patients with primary liver tumors.
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