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. 2024 Jan 8:10:1315097.
doi: 10.3389/fnut.2023.1315097. eCollection 2023.

Effect of sarcopenia on survival in patients after pancreatic surgery: a systematic review and meta-analysis

Lei Zhong #  1 , Jifeng Liu #  1 , Mingquan Xia #  1 , Yunshu Zhang  2 , Shuo Liu  3 , Guang Tan  1
Affiliations

Effect of sarcopenia on survival in patients after pancreatic surgery: a systematic review and meta-analysis

Lei Zhong et al. Front Nutr. .

Abstract

Background: Numerous studies have reported sarcopenia to be associated with unfavorable outcomes in patients who have undergone pancreatectomy. Therefore, in this meta-analysis, we examined the relationship between sarcopenia and survival after pancreatic surgery.

Methods: PubMed, Embase, and Cochrane Library were searched for studies that examined the association between sarcopenia and survival after pancreatic surgery from the inception of the database until June 1, 2023. Hazard ratio (HR) for overall survival (OS) and/or progression-free survival (PFS) of sarcopenia and pancreatic surgery were extracted from the selected studies and random or fixed-effect models were used to summarize the data according to the heterogeneity. Publication bias was assessed using Egger's linear regression test and a funnel plot.

Results: Sixteen studies met the inclusion criteria. For 13 aggregated univariate and 16 multivariate estimates, sarcopenia was associated with decreased OS (univariate analysis: HR 1.69, 95% CI 1.48-1.93; multivariate analysis: HR 1.69; 95% CI 1.39-2.05, I2 = 77.4%). Furthermore, sarcopenia was significantly associated with poor PFS of pancreatic resection (Change to univariate analysis: HR 1.74, 95% CI 1.47-2.05; multivariate analysis: HR 1.54; 95% CI 1.23-1.93, I2 = 63%).

Conclusion: Sarcopenia may be a significant prognostic factor for a shortened survival following pancreatectomy since it is linked to an elevated risk of mortality. Further studies are required to understand how sarcopenia affects long-term results after pancreatic resection.Systematic review registrationRegistration ID: CRD42023438208 https://www.crd.york.ac.uk/PROSPERO/#recordDetails.

Keywords: cancer; meta-analysis; pancreatectomy; sarcopenia; survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Process flow diagram for choosing studies for inclusion in the literature.
Figure 2
Figure 2
Forest plot of the univariate association between sarcopenia and OS for patients after pancreatic surgery.
Figure 3
Figure 3
Forest plot of the multivariate association between sarcopenia and OS for patients after pancreatic surgery.
Figure 4
Figure 4
Forest plot of the association between sarcopenia and OS in both Asians and non-Asians after pancreatic surgery (multivariate analysis).
Figure 5
Figure 5
Forest plot of the univariate association between sarcopenia and PFS for patients with pancreatic cancer after pancreatic surgery.
Figure 6
Figure 6
Forest plot of the multivariate association between sarcopenia and PFS for patients with pancreatic cancer after pancreatic surgery.
Figure 7
Figure 7
Forest plot of the association between OS in patients with PDAC after pancreatic surgery.
See this image and copyright information in PMC

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