Sarcopenia and postoperative morbidity in head & neck cancer: A systematic review and meta-analysis.
[OBJECTIVE] To identify the prognostic value of sarcopenia in surgically treated HNC patients on postoperative morbidity.
- p-value p < 0.0001
- p-value p < 0.00001
- 연구 설계 Systematic review
APA
Xie M, Zhang H, et al. (2026). Sarcopenia and postoperative morbidity in head & neck cancer: A systematic review and meta-analysis.. American journal of otolaryngology, 47(1), 104758. https://doi.org/10.1016/j.amjoto.2025.104758
MLA
Xie M, et al.. "Sarcopenia and postoperative morbidity in head & neck cancer: A systematic review and meta-analysis.." American journal of otolaryngology, vol. 47, no. 1, 2026, pp. 104758.
PMID
41365005
Abstract
[OBJECTIVE] To identify the prognostic value of sarcopenia in surgically treated HNC patients on postoperative morbidity.
[DESIGN] Systematic review and meta-analysis.
[INFORMATION SOURCES, STUDY SELECTION, AND METHODS] EMBASE, MEDLINE, SCOPUS, and CINAHL databases were searched from January 1, 1946 to November 4, 2024. Published trials and observational studies reporting the association of sarcopenia and postoperative complications in surgically treated HNC patients were included. Two reviewers independently screened, extracted, and appraised studies using Covidence. Disagreements were resolved through consensus, and/or by consulting a third reviewer. Data were pooled using a random-effects model in RevMan 5.4.1.
[RESULTS] Of 6345 screened studies, 17 out of the 23 included studies had outcomes which were incorporated in the meta-analysis (2884 patients from studies between 1996 and 2024). The meta-analysis revealed a statistically significant association between sarcopenia and all postoperative complications (odds ratio (OR) 2.26, 95 % CI [1.54, 3.33], p < 0.0001), postoperative complications grade 3 (OR 2.34, 95 % CI [1.80, 3.03], p < 0.00001), fistula (OR 2.64, 95 % CI [1.68, 4.16], p < 0.0001), and flap complications (OR 2.77, 95 % CI [1.58, 4.85], p = 0.0004). Subgroup analysis revealed the high risk of bias studies did not significantly bias the results (p = 0.76), but the different measurements of sarcopenia contributed significant heterogeneity (p < 0.00001). The level of evidence is moderate, primarily due to publication bias, for all outcomes, as per GRADE.
[CONCLUSIONS] In patients undergoing curative surgery for HNC, preoperative sarcopenia is associated with higher odds of postoperative complications.
[DESIGN] Systematic review and meta-analysis.
[INFORMATION SOURCES, STUDY SELECTION, AND METHODS] EMBASE, MEDLINE, SCOPUS, and CINAHL databases were searched from January 1, 1946 to November 4, 2024. Published trials and observational studies reporting the association of sarcopenia and postoperative complications in surgically treated HNC patients were included. Two reviewers independently screened, extracted, and appraised studies using Covidence. Disagreements were resolved through consensus, and/or by consulting a third reviewer. Data were pooled using a random-effects model in RevMan 5.4.1.
[RESULTS] Of 6345 screened studies, 17 out of the 23 included studies had outcomes which were incorporated in the meta-analysis (2884 patients from studies between 1996 and 2024). The meta-analysis revealed a statistically significant association between sarcopenia and all postoperative complications (odds ratio (OR) 2.26, 95 % CI [1.54, 3.33], p < 0.0001), postoperative complications grade 3 (OR 2.34, 95 % CI [1.80, 3.03], p < 0.00001), fistula (OR 2.64, 95 % CI [1.68, 4.16], p < 0.0001), and flap complications (OR 2.77, 95 % CI [1.58, 4.85], p = 0.0004). Subgroup analysis revealed the high risk of bias studies did not significantly bias the results (p = 0.76), but the different measurements of sarcopenia contributed significant heterogeneity (p < 0.00001). The level of evidence is moderate, primarily due to publication bias, for all outcomes, as per GRADE.
[CONCLUSIONS] In patients undergoing curative surgery for HNC, preoperative sarcopenia is associated with higher odds of postoperative complications.
MeSH Terms
Humans; Sarcopenia; Postoperative Complications; Head and Neck Neoplasms; Prognosis; Morbidity
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