(1) Background:We estimated the prevalence and clinical outcomes of sarcopenia among breast cancer patients.(2) Methods:A systematic literature search was carried out for the period between July 2023 and October 2023. Studies with breast cancer patients evaluated for sarcopenia in relation to overall survival (OS), progression-free survival (PFS), relapse of disease (DFS), pathological complete response (pCR), or toxicity to chemotherapy were included.(3) Results:Out of 359 screened studies, 16 were eligible for meta-analysis, including 6130 patients, of whom 5284 with non-MBC. Sarcopenia was evaluated with the computed tomography (CT) scan skeletal muscle index and, in two studies, with the dual-energy x-ray absorptiometry (DEXA) appendicular lean mass index. Using different classifications and cut-off points, overall, there were 2007 sarcopenic patients (33%), of whom 1901 (95%) presented with non-MBC. Sarcopenia was associated with a 33% and 29% higher risk of mortality and progression/relapse of disease, respectively. Sarcopenic patients were more likely to develop grade 3–4 toxicity (OR 3.58, 95% CI 2.11–6.06,p< 0.0001). In the neoadjuvant setting, a higher rate of pCR was observed among sarcopenic patients (49%) (OR 2.74, 95% CI 0.92–8.22).(4) Conclusions:Our meta-analysis confirms the correlation between sarcopenia and negative outcomes, especially in terms of higher toxicity.
(1) 背景：本研究旨在评估乳腺癌患者中肌肉减少症的患病率及其临床结局。 (2) 方法：系统检索了2023年7月至2023年10月期间的相关文献。纳入的研究需涉及乳腺癌患者，并评估肌肉减少症与总生存期（OS）、无进展生存期（PFS）、疾病复发（DFS）、病理完全缓解（pCR）或化疗毒性之间的关联。 (3) 结果：在筛选的359项研究中，16项符合荟萃分析条件，共纳入6130例患者，其中5284例为非转移性乳腺癌患者。肌肉减少症的评估主要采用计算机断层扫描（CT）骨骼肌指数，两项研究采用双能X线吸收测定法（DEXA）四肢瘦体质量指数。根据不同分类和截断值，总体共有2007例（33%）肌肉减少症患者，其中1901例（95%）为非转移性乳腺癌患者。肌肉减少症与死亡风险增加33%、疾病进展/复发风险增加29%相关。肌肉减少症患者发生3-4级毒性的风险更高（OR 3.58，95% CI 2.11–6.06，p<0.0001）。在新辅助治疗背景下，肌肉减少症患者的病理完全缓解率更高（49%）（OR 2.74，95% CI 0.92–8.22）。 (4) 结论：本荟萃分析证实了肌肉减少症与不良结局之间的相关性，尤其在更高毒性风险方面。
Sarcopenia in Breast Cancer Patients: A Systematic Review and Meta-Analysis
肿瘤(癌症)患者之家