Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis
BackgroundSarcopenia, characterized by the loss of muscle mass, strength, and physical ability, occurs with aging and certain chronic illnesses such as chronic liver diseases and cancer. Sarcopenia is common in liver cirrhosis and hepatocellular carcinoma (HCC). Previous reports of association betwe...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.978110/full |
| _version_ | 1811178207820382208 |
|---|---|
| author | Chuan Jiang Yanyan Wang Wei Fu Guozhuan Zhang Xiaoshan Feng Xing Wang Fang Wang Le Zhang Yang Deng |
| author_facet | Chuan Jiang Yanyan Wang Wei Fu Guozhuan Zhang Xiaoshan Feng Xing Wang Fang Wang Le Zhang Yang Deng |
| author_sort | Chuan Jiang |
| collection | DOAJ |
| description | BackgroundSarcopenia, characterized by the loss of muscle mass, strength, and physical ability, occurs with aging and certain chronic illnesses such as chronic liver diseases and cancer. Sarcopenia is common in liver cirrhosis and hepatocellular carcinoma (HCC). Previous reports of association between sarcopenia and prognosis of HCC have been inconsistent. Therefore, the present systematic review and meta-analysis aimed to investigate the impact of sarcopenia on the survival of patients with HCC.MethodsA systematic literature search was conducted using PubMed, EMBASE, and Web of Science electronic databases from inception to May 1, 2022. We included retrospective or prospective studies investigating the association between sarcopenia and overall survival (OS) and/or progression free survival (PFS) of HCC. We applied the Quality in Prognosis Studies (QUIPS) instrument to evaluate the risk of bias and quality of included studies. The primary and secondary outcomes were the associations of sarcopenia with OS and PFS, respectively, expressed by a pooled hazard ratio (HR) and corresponding 95% confidence interval (CI). Subgroup analysis and sensitivity analysis were performed. We further evaluated the publication bias by the funnel plot and Begg’s test.ResultsA total of 42 studies comprising 8,445 patients were included. The majority of included studies were at an overall low risk of bias. The pooled prevalence of sarcopenia was 39% (95% CI: 33–45%) (n = 8,203). Sarcopenia was associated with an increased risk of shorter OS, with a pooled adjusted HR of 1.84 (95% CI: 1.62–2.09). An independent association between sarcopenia and reduced PFS was observed (HR = 1.33, 95% CI: 1.12–1.56).ConclusionThe prevalence of sarcopenia was approximately 39% among patients with HCC. Sarcopenia was independently associated with reduced OS and PFS in HCC irrespective of treatment modalities. It is imperative that interventions aimed at alleviating sarcopenia and restoring muscle mass be implemented in order to improve the survival of patients with HCC.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337797], identifier [CRD42022337797]. |
| first_indexed | 2024-04-11T06:14:37Z |
| format | Article |
| id | doaj.art-d31331352bfb457797d70bf1e67c88b1 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-11T06:14:37Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-d31331352bfb457797d70bf1e67c88b12022-12-22T04:41:06ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-12-01910.3389/fnut.2022.978110978110Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysisChuan Jiang0Yanyan Wang1Wei Fu2Guozhuan Zhang3Xiaoshan Feng4Xing Wang5Fang Wang6Le Zhang7Yang Deng8Department of Anoenterology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan, ChinaHealth Management Center, Qilu Hospital of Shandong University, Jinan, ChinaHealth Management Center, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Pain Management, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaCollege of Clinical and Basic Medical Sciences, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaSchool of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaSchool of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaSchool of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, ChinaBackgroundSarcopenia, characterized by the loss of muscle mass, strength, and physical ability, occurs with aging and certain chronic illnesses such as chronic liver diseases and cancer. Sarcopenia is common in liver cirrhosis and hepatocellular carcinoma (HCC). Previous reports of association between sarcopenia and prognosis of HCC have been inconsistent. Therefore, the present systematic review and meta-analysis aimed to investigate the impact of sarcopenia on the survival of patients with HCC.MethodsA systematic literature search was conducted using PubMed, EMBASE, and Web of Science electronic databases from inception to May 1, 2022. We included retrospective or prospective studies investigating the association between sarcopenia and overall survival (OS) and/or progression free survival (PFS) of HCC. We applied the Quality in Prognosis Studies (QUIPS) instrument to evaluate the risk of bias and quality of included studies. The primary and secondary outcomes were the associations of sarcopenia with OS and PFS, respectively, expressed by a pooled hazard ratio (HR) and corresponding 95% confidence interval (CI). Subgroup analysis and sensitivity analysis were performed. We further evaluated the publication bias by the funnel plot and Begg’s test.ResultsA total of 42 studies comprising 8,445 patients were included. The majority of included studies were at an overall low risk of bias. The pooled prevalence of sarcopenia was 39% (95% CI: 33–45%) (n = 8,203). Sarcopenia was associated with an increased risk of shorter OS, with a pooled adjusted HR of 1.84 (95% CI: 1.62–2.09). An independent association between sarcopenia and reduced PFS was observed (HR = 1.33, 95% CI: 1.12–1.56).ConclusionThe prevalence of sarcopenia was approximately 39% among patients with HCC. Sarcopenia was independently associated with reduced OS and PFS in HCC irrespective of treatment modalities. It is imperative that interventions aimed at alleviating sarcopenia and restoring muscle mass be implemented in order to improve the survival of patients with HCC.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337797], identifier [CRD42022337797].https://www.frontiersin.org/articles/10.3389/fnut.2022.978110/fullsarcopeniaskeletal muscle indexprognosishepatocellular carcinomameta-analysis |
| spellingShingle | Chuan Jiang Yanyan Wang Wei Fu Guozhuan Zhang Xiaoshan Feng Xing Wang Fang Wang Le Zhang Yang Deng Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis Frontiers in Nutrition sarcopenia skeletal muscle index prognosis hepatocellular carcinoma meta-analysis |
| title | Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis |
| title_full | Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis |
| title_fullStr | Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis |
| title_full_unstemmed | Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis |
| title_short | Association between sarcopenia and prognosis of hepatocellular carcinoma: A systematic review and meta-analysis |
| title_sort | association between sarcopenia and prognosis of hepatocellular carcinoma a systematic review and meta analysis |
| topic | sarcopenia skeletal muscle index prognosis hepatocellular carcinoma meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.978110/full |
| work_keys_str_mv | AT chuanjiang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT yanyanwang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT weifu associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT guozhuanzhang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT xiaoshanfeng associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT xingwang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT fangwang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT lezhang associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis AT yangdeng associationbetweensarcopeniaandprognosisofhepatocellularcarcinomaasystematicreviewandmetaanalysis |