Sarcopenia as a Prognostic Marker for Survival in Gastric Cancer Patients Undergoing Palliative Chemotherapy. A Systematic Review and Meta Analysis

Sarcopenia, defined as low-skeletal muscle mass (LSMM), can be assessed by imaging modalities. Our aim was to establish the effect of LSMM on overall survival (OS) and progression-free survival (PFS) in gastric cancer patients undergoing palliative chemotherapy based on a large patient sample. MEDLINE library, Cochrane and SCOPUS databases were screened for the associations between LSMM and mortality in advanced gastric cancer patients. The primary endpoint of the systematic review was the hazard ratio of LSMM on OS and PFS. In total, seven studies were suitable for the analysis and included into the present study. The included studies comprised 668 patients with advanced gastric cancer. The identified frequency of LSMM was 48.05%. The pooled hazard ratio for the effect of LSMM on OS was 1.31 [95% CI 0.96-1.77], p = 0.08, in univariate analysis and 1.21 [95% CI 0.94-1.56], p = 0.13, in multivariate analysis. For PFS, the pooled hazard ratio for the effect of LSMM on PFS was 1.76 [95% CI 0.66-4.66], p = 0.26. LSMM did not significantly affect OS and PFS in patients with advanced gastric cancer undergoing palliative chemotherapy. Further research is needed to elucidate possible influences of LSMM on survival in this tumor entity.