BACKGROUND Numerous studies have suggested an association between sarcopenia in pancreatic cancer and adverse outcomes. This systematic review examines the evidence for the impact of sarcopenia on post-operative complications and survival METHODS: A systematic literature search was conducted to identify randomised and non-randomised studies of sarcopenia in pancreatic cancer. Meta-analyses of intra- and post-operative outcomes were performed (operating time, all complications, major complications, pancreatic fistulae, peri-operative mortality, overall survival). RESULTS Forty-two studies reported the assessment of body composition in 7619 patients. Methods used to assess body composition in patients with pancreatic cancers were computerized tomography (n = 34), bioelectrical impedance analysis (n = 7), and dual-energy-X-ray-absorptiometry (n = 1). Only 10 studies reported the impact of pre-operative sarcopenia upon post-operative outcomes. Sarcopenia was associated with increased peri-operative mortality (OR: 2.40, CI95%:1.19-4.85, p < 0.01) and decreased overall survival by univariable (HR: 1.95, CI95%:1.35-2.81, p < 0.001) and multivariable analysis (HR: 1.78, CI95%:1.54-2.05). Sarcopenia was not significantly associated with all complications (OR: 0.96, CI95%:0.78-1.19) or pancreatic fistula (OR: 0.95, CI95%: 0.59-1.54). CONCLUSIONS Assessment of sarcopenia in pancreatic cancer provides prognostic value but, more importantly, may provide a basis for therapeutic intervention. However, variation in the methods of assessing and reporting sarcopenia in this patient group limits the assessment of post-operative outcomes currently.

中文翻译：

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胰腺癌患者的身体成分评估和肌肉减少症：系统评价和荟萃分析。

背景技术大量研究表明，胰腺癌少肌症与不良后果之间存在关联。这项系统的审查检查了少肌症对术后并发症和生存的影响的证据。方法：进行了系统的文献检索，以鉴定胰腺癌少肌症的随机和非随机研究。进行术中和术后预后的荟萃分析（手术时间，所有并发症，主要并发症，胰瘘，围手术期死亡率，总生存期）。结果42项研究报告了7619例患者的身体成分评估。用于评估胰腺癌患者身体成分的方法是计算机断层扫描（n = 34），生物电阻抗分析（n = 7）和双能X线吸收法（n = 1）。只有10项研究报告了术前肌肉减少症对术后结果的影响。肌肉减少症与围手术期死亡率增加（OR：2.40，CI95％：1.19-4.85，p <0.01）和整体生存率降低之间存在单变量（HR：1.95，CI95％：1.35-2.81，p <0.001）和多变量分析（HR：1.78，CI95％：1.54-2.05）。肌肉减少症与所有并发症（OR：0.96，CI95％：0.78-1.19）或胰瘘（OR：0.95，CI95％：0.59-1.54）没有显着相关性。结论评估少肌症在胰腺癌中具有预后价值，但更重要的是，它可以为治疗干预提供基础。然而，该患者组中评估和报告肌肉减少症的方法不同，目前限制了对术后结局的评估。