Pretreatment sarcopenic assessments help predict gynaecologic cancer outcomes

Pretreatment sarcopenia appears to worsen survival in patients with gynaecologic cancers, such as ovarian (OC), endometrial (EC), and cervical (CC), reports a study. Including this assessment into cancer management may help improve prognosis.

A group of researchers systematically searched four electronic databases (ie, Ovid Medline, Embase, Web of Science, and Cinahl plus) from 2000 to May 2020 in English. They screened titles and abstracts, reviewed eligible full texts, and extracted data from included studies.

Finally, the researchers performed meta-analyses on homogenous survival data and narratively reported heterogenous data.

A total of 767 studies were identified, of which 27 (n=4,286 participants) were eligible for the systematic review. Included studies were all published between 2015 and 2020.

Unadjusted results showed a negative effect of pretreatment sarcopenia on overall survival in ovarian cancer (hazard ratio [HR], 1.40, 95 percent confidence interval [CI], 1.20‒1.64; p<0.0001; n=10), endometrial cancer (HR, 1.42, 95 percent CI, 0.97‒2.10; p=0.07; n=4), and cervical cancer (HR, 1.10, 95 percent CI, 0.93‒1.31; p=0.28; n=5).

A negative effect was also observed on progression-free survival in ovarian cancer (HR, 1.28, 95 percent CI, 1.11‒1.46; p=0.0005; n=8), endometrial cancer (HR, 1.51, 95 percent CI, 1.03‒2.20; p=0.03; n=2), and cervical cancer (HR, 1.14, 95 percent CI, 0.85‒1.53; p=0.37; n=2).

On longitudinal analysis, muscle loss was also found to induce a negative effect on survival. Overall, a high risk of bias was seen in the studies.

“Heterogeneity in sarcopenia assessments makes data interpretation challenging,” the researchers said. “Further research in prospective studies is required.”

Gynaecologic cancers are known to have high mortality rates. Sarcopenia, which negatively affects prognosis, is present in 38.7 percent of cancer patients. Although computed tomography (CT) is routinely performed in oncology, CT assessments of sarcopenia are not usually used to measure prognosis, according to the researchers.