Albano Domenico, Zanardo Moreno, Basile Mariachiara, De Micheli Nicole Alessandra, Berenghi Alessandro, Serpi Francesca, Gitto Salvatore, Messina Carmelo, Sconfienza Luca Maria
IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy.
Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, 20122, Milan, Italy.
Radiol Med. 2025 Jun 3. doi: 10.1007/s11547-025-02016-9.
Sarcopenia has been linked to poor outcomes in various cancers, but its specific effect on sarcoma patients remains unclear. This systematic review and meta-analysis investigates the impact of sarcopenia, estimated using CT, on sarcoma patients, focusing on prognostic implications and associated outcomes.
The PubMed, Embase, and SCOPUS databases were searched up to March 2025. Then, a meta-analysis of the data was performed. Overall survival (OS) and relapse-free survival (RFS) were the endpoints. Hazard ratios and 95% confidence intervals were assessed to evaluate the association between sarcopenia and survival of sarcoma patients.
Eighteen studies with a total of 1699 patients met the inclusion criteria. Liposarcoma was the most reported histotype in 67% of the studies, with extremities being the most common tumor location (50%), and chemotherapy was the primary intervention in 89% of cases, followed by radiation therapy (78%) and surgery (67%). Analyzing seven articles, a pooled HR of 1.91 (95% CI 1.09-3.34) for OS was reached, indicating that sarcopenic patients have a 91% higher risk of mortality compared to non-sarcopenic patients (p < 0.01). There is no evidence of selective publication (p = 0.137). The meta-analysis for the two studies that reported HR of RFS resulted 1.16 (95% CI 0.85-1.59), not significant (p = 0.28). The quality of the included studies demonstrated high methodological rigor.
Worse outcomes have been observed in sarcopenic patients with sarcomas, but the impact of sarcopenia on OS and RFS still remains uncertain, highlighting the need for further research and standardized approaches. Trial Registration The protocol for this review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration unique identifying number: CRD42024578969).
肌肉减少症与多种癌症的不良预后相关，但其对肉瘤患者的具体影响尚不清楚。本系统评价和荟萃分析调查了使用CT评估的肌肉减少症对肉瘤患者的影响，重点关注预后意义和相关结局。
检索截至2025年3月的PubMed、Embase和SCOPUS数据库。然后，对数据进行荟萃分析。总生存期（OS）和无复发生存期（RFS）为终点指标。评估风险比和95%置信区间，以评估肌肉减少症与肉瘤患者生存之间的关联。
18项研究共1699例患者符合纳入标准。在67%的研究中，脂肪肉瘤是报告最多的组织学类型，四肢是最常见的肿瘤部位（50%），89%的病例主要干预措施为化疗，其次是放射治疗（78%）和手术（67%）。分析7篇文章，OS的合并风险比为1.91（95%CI 1.09 - 3.34），表明肌肉减少症患者的死亡风险比非肌肉减少症患者高91%（p < 0.01）。没有选择性发表的证据（p = 0.137）。对两项报告RFS风险比的研究进行的荟萃分析结果为1.16（95%CI 0.85 - 1.59），无统计学意义（p = 0.28）。纳入研究的质量显示出较高的方法学严谨性。
肌肉减少症的肉瘤患者预后较差，但肌肉减少症对OS和RFS的影响仍不确定，这凸显了进一步研究和标准化方法的必要性。试验注册本综述方案已在国际前瞻性系统评价注册库（PROSPERO）数据库中注册（注册唯一识别号：CRD42024578969）。
