Sarcopenia defined by serum creatinine and cystatin C predicts poor survival outcomes in patients with cancers.

BACKGROUND

The prognostic significance of sarcopenia estimated by serum creatinine and cystatin C in cancer patients remained inconsistent. The purpose of the meta-analysis was to comprehensively evaluate the association between creatinine/cystatin C ratio(CCR) or sarcopenia index(SI) and survival outcomes in cancer patients with sarcopenia.

METHODS

A comprehensive search of relevant studies was implemented by scrutinizing Pubmed, Web of science and Embase databases until June 30, 2024. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to evaluate the survival outcomes.

RESULTS

18 studies from 17 articles involving 9908 patients were enrolled in the study. The meta-analysis indicated that low CCR was significantly associated with poor overall survival (OS) (HR:1.71,95% CI: 1.42-2.06), progression free survival (PFS)((HR: 1.76; 95% CI: 1.33-2.34), recurrence free survival (RFS)(HR: 2.48; 95% CI: 1.52-4.05). Low SI was correlated with poor OS (HR: 1.60; 95% CI: 1.21-2.13). Subgroup analysis demonstrated that low CCR was an adverse prognostic marker not affected by cancer type, treatment method, country and analysis type.

CONCLUSIONS

Sarcopenia assessed by CCR or SI predicted unfavorable prognosis in cancer patients. CCR or SI can be used as an effective and convenient indicator of sarcopenia in cancer patients.