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Journal of Gastronenterology and Digestive Diseases
|
Volume 3
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
GASTROENTEROLOGY
International Conference on
Donal O’Connor et al., J Gastroenterol Dig Dis 2018, Volume 3
SARCOPENIA IS HIGHLY PREVALENT
AND ASSOCIATED WITH POORER
OUTCOMES IN PANCREATIC AND
OESOPHAGO-GASTRIC CANCER:
SYSTEMATIC REVIEW AND META-
ANALYSIS
Donal O’Connor
1,2
, Hartnet J
2
, Bashir Y
1
, Mockler D
2
Griffin O
1,2
and
Duggan SN
1
1
Tallaght University Hospital, Ireland
2
Trinity College Dublin, Ireland
Background:
Sarcopenia is a depletion of skeletal muscle mass associated
with increased morbidity and mortality in gastrointestinal malignancy. It has
been increasingly reported with the recent advent of software to measure
sarcopenia using standard staging CT. Patients with pancreatic, oesophageal
and gastric cancer are potentially at increased risk due to nutritional
complications. The aim of this review was to determine the prevalence and
impact of sarcopenia in these malignancies.
Methods:
Systematic literature search of Medline and Embase databases
was developed with a medical librarian and performed by two investigators
following the PRISMA guidelines. (Search period 1990-August 2017). Studies
were included for prevalence and method of sarcopenia measurement were
reported. Other outcome measures included effect on morbidity and survival.
Studies were grouped into pancreatic and oesophago-gastric for analysis.
Pooled estimation(ES) for prevalence was computed using random effects
model and presented with 95% CI.
Results:
After screening 473 titles, 17 observational studies (4206 patients)
in pancreatic and 30 studies (5561 patients) in oesophago-gastric were
analyzed. Prevalence of sarcopenia was higher in pancreatic cancer (49.6%)
compared to oesophago-gastric (34%) ES 0.49(0.39-0.59)v 0.34(0.27-0.4)
There was significant heterogeneity regarding definition of sarcopenia and
reporting of outcome measures. In studies with sufficient data, sarcopenia
was independent of BMI and independently associated with poorer survival
and higher post-operative complications.
Conclusion:
Sarcopenia detected during staging CT was present in half
and one third of patients with pancreatic and oesophago-gastric cancers
respectively and is a poor prognostic indicator. This justifies further research
into the mechanism and potential treatment.
Donal O’Connor is an Assistant Professor/Reg-
istrar, department of surgery in Trinity College
Dublin. He has been nominated for provost
teaching award 2017. His research interest lies
in Pancreatitis Surgical outcomes Undergradu-
ate education: teaching methods Assessment
methods in post graduate surgical examina-
tions.
oconnd15@tcd.ieBIOGRAPHY