Sarcopenia is a degenerative loss of skeletal muscle mass that can be found in the development of cancer cachexia. Based on recent studies, the prevalence of sarcopenia is relatively high in mRCC (metastatic renal cell carcinoma) patients, with the rate of 29-68%. Sarcopenia has been associated with increased adverse outcomes and could be an important predictor of outcomes in some types of cancer. However, the prognostic value of sarcopenia in renal cancer patients is still unclear. Thus, in this systematic review, we aim to evaluate the prognostic value of sarcopenia in mRCC patients.
Data is collected from PMC, PubMed, Scopus, and Science Direct, using combinations of keywords related to Sarcopenia and mRCC. We included studies that investigate sarcopenia in relation to survival and primary chemotoxicity in mRCC patients. Quality of each included study is assessed using the Newcastle-Ottawa Scale (NOS).
A total of 10 studies consisting of 849 mRCC patients were included. According to the NOS, there were 5 studies with good quality, 4 studies with moderate quality, and 1 study with poor quality. The association of sarcopenia and OS (Overall Survival) was found in 4 studies. However, other 5 studies showed that sarcopenia was not associated with OS. Similar results for PFS (Progression Free Survival) were found. Two studies found that sarcopenia was associated with PFS, while other 2 studies found that there was no association between sarcopenia and PFS. There were 3 studies that found a higher DLT (Dose-Limiting Toxicity) rate in sarcopenic patients vs. non sarcopenic patients treated with sunitinib and sorafenib. However, other 2 studies found that there were no significant differences in chemotherapy toxicity between sarcopenic and non-sarcopenic patients treated with tyrosine kinase inhibitor and everolimus.
In this systematic review, we observed that sarcopenia was associated with increased DLT and poor survival in some studies, but the results were inconsistent and conflicting. There were 5 studies with good quality, 4 studies with moderate quality, and 1 study with poor quality. Further investigation is needed with better methods and outcome that focuses on chemotherapy toxicity and quality of life.
The authors.
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All authors have declared no conflicts of interest.