Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
Curr Opin Urol. 2021 Jul 1;31(4):315-323. doi: 10.1097/MOU.0000000000000885.
Sarcopenia is known to affect perioperative and oncologic outcomes in patients with different urological malignancies. Nevertheless, the use of pretreatment sarcopenia as a predictor of clinical outcomes in patients with prostate cancer is still poorly studied. Therefore, we aimed to conduct a systematic review summarizing the available evidence and identifying the prognostic value of sarcopenia in prostate cancer patients.
Sarcopenia was not predictive of biochemical recurrence in patients treated with radical prostatectomy. However, it was associated with worse long-term survival outcomes as well as the likelihood of developing postoperative complications after radical prostatectomy. In the context of radiotherapy, sarcopenia was a predictive factor for overall survival. In patients with hormone-sensitive prostate cancer treated with androgen deprivation, sarcopenia was associated with overall and cancer-specific survival. In patients with castration-resistant prostate cancer, sarcopenia was associated with poorer tolerance to docetaxel-based chemotherapy.
Most studies found sarcopenia to be a predictor for worse perioperative and oncologic outcomes in patients treated with radical surgery, radiotherapy, or systemic therapy for prostate cancer. However, there is significant heterogeneity across the studies in terms of sarcopenia definition. For a better understanding of the prognostic value of sarcopenia in patients with prostate cancer, large-scale prospective studies are needed.
肌少症已知会影响不同泌尿系统恶性肿瘤患者的围手术期和肿瘤学结局。然而，在前列腺癌患者中，术前肌少症作为临床结局预测因子的应用仍研究不足。因此，我们旨在进行一项系统综述，总结现有证据并确定肌少症在前列腺癌患者中的预后价值。
肌少症不能预测接受根治性前列腺切除术治疗的患者的生化复发。然而，它与长期生存结局较差以及接受根治性前列腺切除术后发生术后并发症的可能性相关。在放疗背景下，肌少症是总生存的预测因素。对于接受雄激素剥夺治疗的激素敏感性前列腺癌患者，肌少症与总生存和癌症特异性生存相关。对于接受多西他赛化疗的去势抵抗性前列腺癌患者，肌少症与对化疗的耐受性更差相关。
大多数研究发现肌少症是接受根治性手术、放疗或系统治疗的前列腺癌患者围手术期和肿瘤学结局较差的预测因子。然而，在肌少症定义方面，研究之间存在显著异质性。为了更好地理解肌少症在前列腺癌患者中的预后价值，需要进行大规模前瞻性研究。
