86P - The impact of sarcopenia on chemotherapy toxicity and survival rate among colorectal cancer patients who underwent chemotherapy: A systematic review and meta-analysis

Background

Colorectal cancer (CRC) is the third most commonly diagnosed cancer globally and the second cancer in terms of mortality. The prevalence of sarcopenia in patients with CRC ranges between 12%-60%. It has been described that there is an association between sarcopenia and numerous poor short-term CRC outcomes like increased perioperative mortality, postoperative sepsis, prolonged length of stay, and physical disability. In this study, we review the evidence regarding the impact of sarcopenia and low muscle mass on chemotherapy toxicity and survival among colorectal patients who underwent chemotherapy.

Methods

A systematic review was performed according to PRISMA guidelines. A literature search was conducted by two independent reviewers on all studies that included sarcopenia in colorectal cancer patients who underwent chemotherapy using PubMed, PubMed central, and Google Scholar databases. Study included elderly population was excluded. Outcome of interest included chemotherapy toxicity and overall survival. Data synthesis and statistical analysis were carried out using Review Manager software.

Results

A total of 2206 patients from 14 studies were included in our meta-analysis. In our overall analysis of chemotherapy toxicity, we indicated that CRC patients with sarcopenia would have higher incidence of chemotherapy toxicity (OR = 1.91, 95% CI = 1.37 – 2.67, P < 0.001) including grade 3/4 neutropenia, peripheral neuropathy, nausea and vomiting, also diarrhea. Regarding survival outcomes, our results showed that sarcopenia associated with a decreased overall survival (HR = 1.64, 95% CI 1.36 – 1.98, P < 0.001). These effects of sarcopenia and low muscle mass on chemotherapy toxicity and overall survival were observed among various chemotherapy regimens and across disease stages.

Conclusions

Sarcopenia and low muscle mass can give negative impact on chemotherapy toxicities and survival outcomes for colorectal cancer patients who underwent chemotherapy. Prospective studies with a uniform definition of sarcopenia are still needed to update our findings.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.