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Review
. 2020 Jan 11;9(1):199.
doi: 10.3390/jcm9010199.

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

Alicia S Borggreve  1   2 , Robin B den Boer  1 , Gijs I van Boxel  1 , Pim A de Jong  3 , Wouter B Veldhuis  3 , Elles Steenhagen  4 , Richard van Hillegersberg  1 , Jelle P Ruurda  1
Affiliations
Review

The Predictive Value of Low Muscle Mass as Measured on CT Scans for Postoperative Complications and Mortality in Gastric Cancer Patients: A Systematic Review and Meta-Analysis

Alicia S Borggreve et al. J Clin Med. .

Abstract

Risk assessment is relevant to predict outcomes in patients with gastric cancer. This systematic review aimed to investigate the predictive value of low muscle mass for postoperative complications in gastric cancer patients. A systematic literature search was performed to identify all articles reporting on muscle mass as measured on computed tomography (CT) scans in patients with gastric cancer. After full text screening, 15 articles reporting on 4887 patients were included. Meta-analysis demonstrated that patients with low muscle mass had significantly higher odds of postoperative complications (odds ratio (OR): 2.09, 95% confidence interval (CI): 1.55-2.83) and severe postoperative complications (Clavien-Dindo grade ≥III, OR: 1.73, 95% CI: 1.14-2.63). Moreover, patients with low muscle mass had a significantly higher overall mortality (hazard ratio (HR): 1.81, 95% CI: 1.52-2.14) and disease-specific mortality (HR: 1.58, 95% CI: 1.36-1.84). In conclusion, assessment of muscle mass on CT scans is a potential relevant clinical tool for risk prediction in gastric cancer patients. Considering the heterogeneity in definitions applied for low muscle mass on CT scans in the included studies, a universal cutoff value of CT-based low muscle mass is required for more reliable conclusions.

Keywords: CT scan; gastrectomy; gastric cancer; muscle mass; prognostication; risk factors; sarcopenia.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of literature search.
Figure 2
Figure 2
Overview of risk of bias of the included studies after Quality in Prognosis Studies (QUIPS) assessment.
Figure 3
Figure 3
Forest plots of univariable and multivariable odds ratios for postoperative complications for gastric cancer patients with low muscle mass versus normal muscle mass.
Figure 4
Figure 4
Forest plots of univariable and multivariable odds ratios for severe postoperative complications for gastric cancer patients with low muscle mass versus normal muscle mass.
Figure 5
Figure 5
Forest plots of univariable and multivariable hazard ratios for overall mortality for gastric cancer patients with low muscle mass versus normal muscle mass.
Figure 6
Figure 6
Forest plots of univariable and multivariable hazard ratios for disease-specific mortality for gastric cancer patients with low muscle mass versus normal muscle mass.
See this image and copyright information in PMC

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