Effect of sarcopenia on clinical outcomes following digestive carcinoma surgery: a meta-analysis

  • Hongxia Hua
  • Xinyi Xu
  • Yu Tang
  • Ziqi Ren
  • Qin XuEmail author
  • Li Chen
Review Article



The effect of sarcopenia on digestive carcinoma surgery outcomes is controversial. We aimed to assess the effect of sarcopenia defined by the European Working Group on Sarcopenia in Older People (EWGSOP) or the Asian Working Group for Sarcopenia (AWGS) on outcomes following digestive carcinoma surgery.


Eligible studies were searched from PubMed, EMBASE and other databases from inception to April 2018. We conducted a meta-analysis to estimate the risk ratios or mean differences of outcomes in the sarcopenia group versus the non-sarcopenia group. Stratified analyses and sensitivity analyses were performed.


We included 11 cohort studies, with a sarcopenia prevalence ranging from 11.6 to 33.0%. Sarcopenia was associated with an increased risk of total complications (RR = 1.87, P < 0.00001), major complications (RR = 2.45, P = 0.002), re-admissions (RR = 2.53,P < 0.0001), infections (RR = 2.23, P = 0.09), severe infections (RR = 2.96, P = 0.04), 30-day mortality (RR = 3.36, P = 0.001), longer hospital stay (MD = 4.61, P = 0.001) and increased hospitalization expenditures (SMD = 0.25, P = 0.02). Sarcopenia differentially affected outcomes when stratified, and the results were stable.


Sarcopenia defined by the EWGSOP or AWGS Consensus was a high-risk factor for digestive carcinoma surgery outcomes. Different tumour site and muscle mass measurements are the sources of heterogeneity. More high-quality studies are needed.


Sarcopenia Digestive carcinoma Surgery Clinical outcomes 


Funding information

This work was funded by the Postgraduate Research & Practice Innovation Program of Jiangsu Province awarded to Xu Xinyi.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hongxia Hua
    • 1
  • Xinyi Xu
    • 1
  • Yu Tang
    • 2
  • Ziqi Ren
    • 1
  • Qin Xu
    • 1
    Email author
  • Li Chen
    • 3
  1. 1.School of NursingNanjing Medical UniversityNanjingChina
  2. 2.Department of Thoracic Surgerythe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  3. 3.Department of General Surgerythe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina

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