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      Impact of sarcopenia on the prognosis and treatment of lung cancer: an umbrella review

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          Abstract

          Background

          Lung cancer is the leading cause of cancer-related mortality worldwide. Sarcopenia, defined as the loss of muscle mass and function, is known to cause adverse health outcomes. The purpose of this umbrella review was to integrate published systematic reviews and meta-analyses exploring sarcopenia and lung cancer to provide comprehensive knowledge on their relationship.

          Methods

          Eligible studies were searched from scientific databases until June 28, 2022. Critical appraisal was performed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2. The impact of sarcopenia on the pathophysiology, prevalence, and prognosis of lung cancer is summarized at the level of systematic reviews or meta-analyses.

          Results

          Fourteen reviews and meta-analyses were conducted. The methodological quality was high for one review, low for nine, and critically low for four. The most common standard for diagnosing sarcopenia in the lung cancer population is computed tomography (CT) to measure the skeletal muscle index at the third lumbar vertebra (L3). Sarcopenia was highly prevalent among patients with lung cancer, with a pooled prevalence ranging from 42.8% to 45.0%. The association between sarcopenia and increased postoperative complications and decreased disease control rates with immune checkpoint inhibitors has been demonstrated. Mortality was significantly higher in sarcopenic patients than in non-sarcopenic patients with lung cancer, regardless of the stage of disease or type of treatment.

          Conclusions

          Sarcopenia is a poor prognostic factor for lung cancer. Future studies are necessary to clarify the pathophysiology of sarcopenia and develop effective interventions for sarcopenia in patients with lung cancer.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s12672-022-00576-0.

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Sarcopenia: revised European consensus on definition and diagnosis

            Alfonso Cruz-Jentoft, Gulistan Bahat, Jürgen Bauer … (2018)
            Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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              AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

              Beverley Shea, Barnaby Reeves, George Wells … (2017)
              The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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                Author and article information

                Contributors
                Ke-Vin Chang: kvchang011@gmail.com
                Journal
                Journal ID (nlm-ta): Discov Oncol
                Journal ID (iso-abbrev): Discov Oncol
                Title: Discover. Oncology
                Publisher: Springer US (New York )
                ISSN (Electronic): 2730-6011
                Publication date (Electronic): 28 October 2022
                Publication date PMC-release: 28 October 2022
                Publication date Collection: December 2022
                Volume: 13
                Electronic Location Identifier: 115
                Affiliations
                [1 ]GRID grid.416104.6, Department of Physical Medicine and Rehabilitation, , Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, ; Yilan, Taiwan
                [2 ]GRID grid.412094.a, ISNI 0000 0004 0572 7815, Department of Internal Medicine, , National Taiwan University Hospital, Yunlin Branch, ; Douliu, Yunlin Taiwan
                [3 ]GRID grid.19188.39, ISNI 0000 0004 0546 0241, Department of Physical Medicine and Rehabilitation, , National Taiwan University Hospital, College of Medicine, National Taiwan University, ; Taipei, Taiwan
                [4 ]GRID grid.412094.a, ISNI 0000 0004 0572 7815, Department of Physical Medicine and Rehabilitation, , National Taiwan University Hospital, Bei-Hu Branch, ; Taipei, Taiwan
                [5 ]GRID grid.260539.b, ISNI 0000 0001 2059 7017, Institute of Clinical Medicine, , National Yang Ming Chiao Tung University, ; Taipei, Taiwan
                [6 ]Congenital Heart Disease Study Group, Asian Society of Cardiovascular Imaging, Seoul, Korea
                [7 ]InnovaRad Inc., Taichung, Taiwan
                [8 ]GRID grid.412896.0, ISNI 0000 0000 9337 0481, Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, , Taipei Medical University, ; Taipei, Taiwan
                [9 ]GRID grid.14442.37, ISNI 0000 0001 2342 7339, Department of Physical and Rehabilitation Medicine, , Hacettepe University Medical School, ; Ankara, Turkey
                Article
                Publisher ID: 576
                DOI: 10.1007/s12672-022-00576-0
                PMC ID: 9616989
                PubMed ID: 36307591
                SO-VID: e59fa17c-d98d-4c8c-ac43-b8798ad546fd
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 13 September 2022
                Date accepted : 17 October 2022
                Funding
                Funded by: National Taiwan University Hospital, Bei-Hu Branch
                Funded by: Ministry of Science and Technology
                Award ID: MOST 106-2314-B-002-180-MY3 and 109-2314-B-002-114-MY3
                Award Recipient :
                Funded by: Taiwan Society of Ultrasound in Medicine
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © The Author(s) 2022

                Keywords: muscle loss,pulmonary,malignancy,frailty,prognosis
                Data availability:
                Keywords: muscle loss, pulmonary, malignancy, frailty, prognosis

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