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Gastric Cancer

, Volume 22, Issue 1, pp 10–22 | Cite as

Body composition assessment and sarcopenia in patients with gastric cancer: a systematic review and meta-analysis

  • Sivesh K. Kamarajah
  • James Bundred
  • Benjamin H. L. TanEmail author
Review Article
  • 376 Downloads

Abstract

Introduction

There has recently been increased interest in the assessment of body composition in patients with gastric cancer for the purpose of prognostication. This systematic review and meta-analysis aim to evaluate the current literature on body composition assessment in patients with gastric cancer and its impact on peri-operative outcomes.

Methods

A systematic literature search was conducted for studies reporting assessment of body composition in patients with gastric cancers. Meta-analysis of postoperative outcomes (overall and major complications, anastomotic leaks, pulmonary complications) and survival was performed using random effects models.

Results

Thirty-nine studies reported the assessment of body composition in 8402 patients. Methods used to assess body composition in patients with gastric cancers were computerized tomography (n = 26), bioelectrical impedance analysis (n = 9), and dual-energy-X-ray-absorptiometry (n = 3). Only 21 studies reported the impact of pre-operative sarcopenia on post-operative outcomes. Sarcopenic patients have significantly higher rates of postoperative major complications (n = 12, OR 1.67, CI95% 1.14–2.46, p = 0.009), and pulmonary (n = 8, OR 4.01, CI95% 2.23–7.21, p < 0.001) complications after gastrectomy. Meta-analysis of nine studies reporting overall survival after gastrectomy identified significantly worse survival in patients with pre-operative sarcopenia (HR 2.12, CI95% 1.89–2.38, p < 0.001).

Conclusions

Assessment of body composition has the potential to become a clinically useful tool that could support decision-making in patients with gastric cancer. However, variation in methods of assessing and reporting body composition in this patient group limits assessment of current post-operative outcomes

Keywords

Gastric Cancer Gastrectomy Sarcopenia Body composition Outcomes Survival 

Notes

Funding

None declared.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was a systematic review and meta-analysis of all published literature and institutional review deemed this study exempt from full ethical review.

Supplementary material

10120_2018_882_MOESM1_ESM.docx (10.9 mb)
Supplementary material 1 (DOCX 11137 KB)

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  1. 1.Department of Upper Gastrointestinal SurgeryQueen Elizabeth Hospital BirminghamBirminghamUK

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