Effect of sarcopenia on clinical outcomes following digestive carcinoma surgery: a meta-analysis

BackgroundThe effect of sarcopenia on digestive carcinoma surgery outcomes is controversial. We aimed to assess the effect of sarcopenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP) or the Asian Working Group for Sarcopenia (AWGS) on outcomes following digestive carcinoma surgery.MethodsEligible studies were searched from PubMed, EMBASE and other databases from inception to April 2018. We conducted a meta-analysis to estimate the risk ratios or mean differences of outcomes in the sarcopenia group versus the non-sarcopenia group. Stratified analyses and sensitivity analyses were performed.ResultsWe included 11 cohort studies, with a sarcopenia prevalence ranging from 11.6 to 33.0%. Sarcopenia was associated with an increased risk of total complications (RR=1.87, P<0.00001), major complications (RR=2.45, P=0.002), re-admissions (RR=2.53,P<0.0001), infections (RR=2.23, P=0.09), severe infections (RR=2.96, P=0.04), 30-day mortality (RR=3.36, P=0.001), longer hospital stay (MD=4.61, P=0.001) and increased hospitalization expenditures (SMD=0.25, P=0.02). Sarcopenia differentially affected outcomes when stratified, and the results were stable.ConclusionsSarcopenia defined by the EWGSOP or AWGS Consensus was a high-risk factor for digestive carcinoma surgery outcomes. Different tumour site and muscle mass measurements are the sources of heterogeneity. More high-quality studies are needed.