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Copyright ©The Author(s) 2022.
World J Gastrointest Oncol. Feb 15, 2022; 14(2): 423-433
Published online Feb 15, 2022. doi: 10.4251/wjgo.v14.i2.423
Table 1 Included studies with the main outcome measures
Ref.
Type of study
Measure of muscle mass
Definition of sarcopenia
CT
Inclusion criteria
Exclusion criteria
Pts age
Mean outcome
Follow-up (mo)
Results
Berkel et al[22], 2019RetrospectiveTPA and TAMA at L3 and both the superior and inferior border of L4 (+ measurement of skeletal muscle radiation attenuation)Normalized TPA or TAMA at each level below the median (males and females) After NCRTcT3 or cT4 (CRM < 1 mm) and/or cN2 rectal cancer undergoing NCRTNo preoperative CT scan or of poor quality99; 66 (40-81)Correlation between TAMA radiation attenuation and OS Median: 32.9 (range: 19.4-51.1)Sarcopenia (at TAMA L4 inferior) correlated to OS
Choi et al[23], 2018RetrospectiveSkeletal muscle index at L3 levelSMI < 52.4 cm2/m2 for male and 38.5 cm2/m2 for femaleBefore NCRTcT ≥ 3 or cN ≥ 1 rectal cancer undergoing NCRTMetastasis/recurrence. No CT at initial diagnosis188; 61.3 (27-84)Correlation between SMI and OS and DFSMedian: 52 (range: 5-91)Worse OS in sarcopenic patients
Chung et al[24], 2020RetrospectiveSkeletal muscle index at L3 levelSMI < 52.4 cm2/m2 for male and < 38.5 cm2/m2 for femaleBefore and after NCRTLocally advanced non metastatic rectal cancer undergoing NCRTNot reported93Correlation between SMI and skeletal muscle loss during NCRT and OS and DFSNot found Worse 5-yr OS in sarcopenic pts after NCRT. Worse OS in pts with severe muscle loss during NCRT. CT4 independent risk factor for severe muscle loss
De Nardi et al[25], 2020RetrospectiveSkeletal muscle index at L3 level SMI < 52 cm2/m2 for male and < 42 cm2/m2 for femaleBefore and after NCRTcT ≥ 3 and N+ cancers undergoing NCRTNot reported52; 63 (32-79)Correlation between skeletal muscle change during NCRT and OS and DFS Median: 56 (range: 32-8)Worse DFS in pts with SML > 2%. In stage II subgroup, worse DFS in SML > 2% or > 5%
Fukuoka et al[26], 2019RetrospectivePsoas muscle index at the level of the navel No definitionBefore and after NCRT or NACcT3N+ rectal cancer undergoing NCRT or NAC Distant metastasis. History of other malignancies47; 66 (27-88)Correlation between change in PMI during neoadjuvant treatment and OS and DFSMedian: 24.1Worse OS and DFS in patients with PMI decrease > 10%
Levolger et al[27], 2018RetrospectiveSkeletal muscle index at L3 levelSMI < 52 cm2/m2 for male and < 39.5 cm2/m2 for female Before and after NCRTcT3 and cT4 rectal cancer and/or cN+ undergoing NCRTNot reported12261 (53-66.3)Correlation between change in skeletal muscle mass during NCRT and OS, DFS, metastasesMedian: 41 (range: 26-62)Lower SMI in patients with cT4 tumors than cT3. SMI variation associated to worse DFS and metastases
Park et al[28], 2018RetrospectiveSkeletal muscle index at L3 levelSMI < 55 cm2/m2 for male and < 39 cm2/m2 for femaleBefore NCRT> 65-yr-old pts with rectal cancer undergoing NCRTRT or CT alone30; 72 (66-87)Correlation between sarcopenia and OS and DFS Median: 98.2 (range 73.5-122.8)Worse OS and DFS in sarcopenic patients
Takeda et al[29], 2018RetrospectiveSkeletal muscle index at L3 levelSMI < 45 cm2/m2 for male and 33.8 cm2/m2 for femaleBefore NCRTcII or cIII advanced rectal cancer undergoing NCRTLack of baseline CT scan144. Sarcopenic: 65 (42-81). Not sarcopenic: 60 (32-65)Correlation between sarcopenia and OS and DFSMedian: 67 (range: 5.7-137.1)Worse OS and DFS in sarcopenic patients