Computed Tomography-Based Sarcopenia and Pancreatic Cancer Survival-A Comprehensive Meta-Analysis Exploring the Influence of Definition Criteria, Prevalence, and Treatment Intention

Antonio Jesús Láinez Ramos-Bossini ^1,2,3, Antonio Gámez Martínez ¹, David Luengo Gómez ^1,2

⁰Department of Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.

Cancers +

|

February 26, 2025

View abstract on PubMed

Summary

Computed tomography (CT)-based sarcopenia is linked to worse overall survival (OS) and progression-free survival (PFS) in pancreatic cancer (PC) patients. Standardizing CT-based sarcopenia assessment is crucial for reliable prognostic information.

Area Of Science

Oncology
Radiology
Geriatrics

Background

Sarcopenia is a known risk factor for poor outcomes in pancreatic cancer (PC).
Existing research on CT-based sarcopenia in PC is inconsistent regarding methodology and outcomes.
This meta-analysis addresses the heterogeneity by evaluating CT-based sarcopenia's impact on survival in PC patients.

Purpose Of The Study

To assess the association between CT-defined sarcopenia and overall survival (OS) and progression-free survival (PFS) in pancreatic cancer (PC) patients.
To investigate the influence of confounding factors like CT measurement methods, sarcopenia thresholds, and treatment intent on this association.
To provide a comprehensive analysis of existing evidence through meta-analysis.

Main Methods

Systematic literature search for observational studies reporting hazard ratios (HRs) for OS and PFS in PC patients with sarcopenia.
Random-effects models to calculate pooled crude and adjusted HRs.
Subgroup analyses were performed based on sarcopenia measurement methods, cutoff values, prevalence, and treatment intention.

Main Results

Sarcopenia was significantly associated with worse OS (pooled aHR = 1.39) and PFS (pooled aHR = 1.31) in PC patients.
Stricter sarcopenia cutoffs and curative treatment intentions showed stronger negative associations with survival outcomes.
Substantial heterogeneity was observed, with potential publication bias for OS.

Conclusions

CT-determined sarcopenia is an independent predictor of poor OS and PFS in PC.
The prognostic value of sarcopenia varies with definition cutoffs and treatment intent.
Standardization of sarcopenia assessment methods is recommended for clinical practice and future research.

Keywords:

meta-analysis overall survival pancreatic cancer progression-free survival sarcopenia

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