Sarcopenia, sarcopenic obesity, myosteatosis as factors of poor prognosis in gastrointestinal tract tumors: sistematic review

Abstract

Background. Gastrointestinal (GI) tract cancer includes a broad spectrum of tumors with generally high prevalence and poor prognosis. Over the past decade sarcopenia (skeletal muscle depletion), myosteatosis, sarcopenic obesity were all shown to have a negative prognostic impact in patients with various malignancies. However, the role of myosteatosis in patients with GI tumors remains controversial.
 Aim. To summarize recent literature regarding the impact of myosteatosis on the surgical treatment of patients with GI malignancies.
 Materials and methods. PubMed, Cochrane Library and ClinicalTrials.gov databases were searched for relevant original studies published between Jan. 2011 and Dec. 2021. The risk of bias of the included studies was assessed using Newcastle-Ottawa Scale (NOS).
 Results. 34 studies comprising 15 295 patients were included. Patients with myosteatosis had significantly poorer overall survival (hazard ratio 0,506, 95% confidence interval 0,4310,595; p0,05). There was no significant influence of myosteatosis on recurrence-free survival (hazard ratio 0,658, 95% confidence interval 0,3891,112; p0,05). Myosteatosis was significantly associated with the occurrence of major postoperative complications in 6 studies. However, only 3 studies supported the impact of myosteatosis on mortality.
 Conclusion. This meta-analysis demonstrates that patients with preoperative myosteatosis have poor long-term survival following treatment for GI malignancy. Therefore, myosteatosis might be used as a prognostic tool. However, more studies with standardized definitions and cut-offs are required.