Head and neck cancer (HNC) was the seventh most common cancer worldwide in 2018. As much as 330,000 people die annually from HNC. Sarcopenia as a result of chemotherapy toxicity or other factors is ubiquitous in HNC patients. This meta-analysis aims to analyze the significance of sarcopenia to predict overall survival in HNC patients receiving chemotherapy.
A systematic review was performed according to PRISMA guidelines. A literature search was conducted by three independent reviewers on all of the studies that include sarcopenia in HNC patients undergoing chemotherapy using PubMed and PubMed central databases. The outcome of interest in this study is the overall survival. Data synthesis and statistical analysis were carried out using Review Manager Software.
A total of 5 studies including 1,088 HNC patients undergoing chemotherapy met the inclusion criteria for this meta-analysis. All studies included were observational studies. This meta-analysis uncovered that there is a significant correlation between the existence of sarcopenia and overall survival in HNC patients receiving chemotherapy (HR 1.50; 95% CI 1.15-1.95; P< 0.003). The quality of the studies was assessed with the Newcastle Ottawa Scale (NOS) shows “good” quality in all included studies.
Our meta-analysis shows that the presence of sarcopenia predicts worse overall survival of HNC patients undergoing chemotherapy. This finding can be used by physicians to improve the assessment of risk and benefit of initiating or continuing chemotherapy in these patients. Further study needs to evaluate in better patient selection and adjusting the confounder.
The authors.
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All authors have declared no conflicts of interest.