Presentation (CTI)

OBJECTIVES: Sarcopenia is a risk factor for adverse clinical outcomes in patients with lung cancer, including poor treatment tolerance, shortened survival, and impaired quality of life. Diagnosis depends on adopted consensus definitions and cutoff values; thus, prevalence rates are generally heterogeneous. We conducted a systematic review and meta-analysis to investigate the global prevalence of sarcopenia and its associated risk factors in patients with lung cancer.
METHODS: A systematic search was conducted using common medical databases for observational studies reporting the prevalence of sarcopenia in lung cancer. We included studies using diagnostic criteria recommended by the Asian Working Group for Sarcopenia (AWGS), and objective CT-based measurement. Subgroup analyses by study design, assessment tools, country economy level, and gender were performed. Pooled prevalence and odds ratios (OR) were obtained using random-effect models.
RESULTS: A total of 7 studies involving 1960 patients were included in this systematic review and meta‑analysis. The global pooled prevalence of sarcopenia in lung cancer was 34.0% (95% confidence interval [CI]: 21.0%-51.0%). Subgroup analyses showed that prevalence did not differ significantly by study design, assessment tools, or economic status (all P > 0.05). For risk factors, low serum albumin was a protective factor for sarcopenia (OR = 0.86, 95% CI: 0.79-0.93, P < 0.001). However, age (OR = 0.97, 95% CI: 0.86-1.09, P = 0.60) and body mass index (BMI) (OR = 0.58, 95% CI: 0.26-1.27, P = 0.17) were not significantly associated with sarcopenia risk.
CONCLUSIONS: We found a high global prevalence of sarcopenia in patients with lung cancer. Serum albumin was a significant modifiable protective factor, whereas age and BMI showed no independent association. Clinicians should be aware of regularly screening and evaluating sarcopenia in patients with lung cancer to enable early intervention and improve clinical outcomes.