Pancreatic cancer (PC) is the most lethal cancer. Pancreatic cancer patients have multiple risk factors for sarcopenia and loss of skeletal muscle mass (LSMM), which may cause greater treatment toxicities, reduced response to cancer therapy, prolonged hospitalization, impaired quality of life, and worse prognosis. The aim of this study was to study the impact of sarcopenia on chemotherapy toxicity and survival among pancreatic cancer patients who underwent chemotherapy.
A systematic review and meta-analysis was performed according to PRISMA guidelines. A literature search was conducted by two independent reviewers on all studies that included sarcopenia in hepatocellular carcinoma patients who underwent chemotherapy using PubMed, PubMed central, and Google Scholar databases. Study included elderly population was excluded. Outcome of interest included chemotherapy toxicity and overall survival. Data synthesis and statistical analysis were carried out using Review Manager software.
A total of 11 studies were eligible for meta-analysis including a total of 1274 pancreatic cancer patients. All included studies were observational studies. Meta-analysis revealed a significant association between sarcopenia and overall survival (HR 1.42; 95% CI 1.20 – 1.68; P < 0.001). Sarcopenia was also associated with incidence of chemotherapy toxicity (OR 2.54; 95% CI 1.19 – 5.43; P = 0.02), including neutropenia, anemia, and thrombocytopenia. The quality of study assessed with Newcastle Ottawa Scale (NOS) showed “good” quality in all included studies.
Sarcopenia can give negative impact on chemotherapy toxicities and survival outcomes for pancreatic cancer patients who underwent chemotherapy. Therefore, it is important to diagnose and treat sarcopenia to reduce the chemotherapy toxicity and mortality in pancreatic cancer patients.
The authors.
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All authors have declared no conflicts of interest.