Table 2.
Summary of long-term survival outcomes in sarcopenic patients in eight studies
| Ref. | No. of patients | Indication | Operation | Assessment of sarcopenia | Cut-off points for sarcopenia | Outcomes | P value | |
| Peng et al[14], 2012 | 557 | Pancreatic cancer | PD and DP | Total psoas index | Lowest quartile of the study cohort | 3-yr survival, male | Sarcopenic: 20.3% Non-sarcopenic: 39.2% | < 0.05 |
| 3-yr survival, female | Sarcopenic: 26.1% Non-sarcopenic: 40.8% | < 0.05 | ||||||
| Amini et al[31], 2015 | 763 | Pancreatic adenocarcinoma | PD, DP and TP | Total psoas volume (adjusted for height), total psoas index | Cut-off value from Peng et al[14] | OS | Sarcopenia as independent risk factor | < 0.001 |
| UV: HR 1.72, 95%CI: 1.36–2.19 MV: HR 1.11, 95%CI: 1.11–1.91 | 0.006 | |||||||
| Joglekar et al[46], 2015 | 180 | Pancreatic adenocarcinoma | PD and DP | Total psoas index | Lowest quartile of the study cohort | OS | No significant difference | 0.44 |
| Okumura et al[45], 2015 | 230 | Pancreatic adenocarcinoma | PD, DP and TP | Total psoas index (measured at umbilical level) | Calculated from receiver-operating characteristic curves | Median OS | Sarcopenic: 17.7 mo Non-sarcopenic: 33.2 mo | < 0.001 |
| DFS | Significantly shorter survival in sarcopenic group | < 0.001 | ||||||
| Onesti et al[66], 2016 | 270 | Both benign and malignant conditions | PD, DP, central and TP | Total psoas area | Lowest tertile of the study cohort | OS | Significantly worse survival for sarcopenic group in females only | 0.005 |
| Ninomiya et al[67], 2017 | 265 | Pancreatic adenocarcinoma | PD, DP and TP | Total abdominal muscle area (adjusted for height) | Cut-off value from Prado et al[39] | Median OS | Sarcopenic: 23.7 mo Non-sarcopenic: 25.8 mo | 0.185 |
| Van Dijk et al[47], 2017 | 199 | Cancer of pancreatic head, ampulla, distal bile duct or duodenum | PD | Total abdominal muscle area (adjusted for height), radiation attenuation of skeletal muscle at L3 | Lowest tertile of the study cohort | Median OS | No difference when total abdominal muscle area was compared | Not reported |
| Significantly shorter survival in patients with low radiation attenuation | 0.008 | |||||||
| Sugimoto et al[68], 2018 | 323 | Pancreatic adenocarcinoma | PD, DP and TP | Total abdominal muscle area (adjusted for height) | Cut-off value from Fearon et al[29] | OS | No significant difference | 0.412 |
| DFS | No significant difference | 0.390 | ||||||
| Lowest quartile from study cohort | OS | No significant difference | 0.075 | |||||
| DFS | No significant difference | 0.172 | ||||||
PD: Pancreaticoduodenectomy; DP: Distal pancreatectomy; TP: Total pancreatectomy; OS: Overall survival; DFS: Disease-free survival; UV: Univariate analysis; HR: Hazard ratio; CI: Confidence interval; MV: Multivariate analysis.