Incidence and risk factors of sarcopenia in gastric cancer patients: a meta-analysis and systematic review.

[BACKGROUND] This meta-analysis was to assess the incidence and risk factors of sarcopenia in gastric cancer (GC) patients and to provide clinical implications for the prevention and improvement of sarcopenia in GC patients.

[METHODS] PubMed, Embase, Cochrane, Web of Science, CNKI, Wanfang, and VIP databases (language was limited to Chinese and English) were searched for observational studies. The random-effects model was used to analyze the incidence of GC combined with sarcopenia and the odd ratio (OR) and 95% confidence interval (CI) of risk factors.

[RESULTS] 1244 studies were retrieved and 20 eligible studies were included. The meta-analysis revealed that the incidence of sarcopenia in GC patients was 26.6% (95% CI: 21%~32%). Age (OR = 1.128, 95% CI: 1.056 ~ 1.204, P < 0.001), male (OR = 1.054, 95% CI: 0.620 ~ 1.791, P < 0.005), body mass index (OR = 1.117, 95% CI: 0.881 ~ 1.414, P < 0.001), nutritional risk screening 2002 (OR = 3.953, 95% CI: 2.038 ~ 7.668, P < 0.05), and tumor diameter > 3 cm (OR = 1.515, 95% CI: 1.021 ~ 2.248, P < 0.05) may be risk factors for sarcopenia in GC patients. In contrast, tumor stage (OR = 1.907, 95% CI: 0.967 ~ 3.763, P > 0.05), gastrectomy approach (OR = 1.837, 95% CI: 1.237 ~ 2.727, P > 0.05), differentiation type (OR = 0.586, 95%CI: 0.325 ~ 1.059, P > 0.05), and severe adverse reactions (NLR, HB, ALB) after chemotherapy (OR = 0.926, 95%CI: 0.793 ~ 1.082, P > 0.05) had no significant correlation with sarcopenia in GC patients.

[CONCLUSIONS] This meta-analysis shows an increased prevalence of sarcopenia in GC patients. This analysis, which focused on Asian populations, suggested that high nutritional risk was a risk factor for sarcopenia in GC patients. Age over 65 years and tumor diameter over 3 cm may be risk factors for sarcopenia. Men may be prone to sarcopenia. Targeting these risk factors may be beneficial in the prevention of sarcopenia in GC patients.