Association between cancer cachexia and treatment-related adverse outcomes in patients with gastrointestinal cancers: a systematic review and meta-analysis.

PURPOSE: Cachexia represents a critical nutritional problem, especially among patients with gastrointestinal cancer, and is potentially linked to unfavorable outcomes. Nevertheless, the influence of cancer cachexia on treatment-related adverse events in these patients remains insufficiently incorporated into current understanding. This systematic review and meta-analysis investigated the association between cancer cachexia and treatment-related adverse outcomes in patients with gastrointestinal cancers.

METHODS

Five electronic databases were searched for relevant studies. Cohort studies investigating the association of cachexia with postoperative complications, chemotherapy-related adverse events, radiotherapy-related adverse events, length of hospital stay, and readmission in patients with gastrointestinal cancers were included.

RESULTS

Thirty-four studies involving 27,473 participants were included. Cancer cachexia was significantly associated with higher odds of postoperative complications (odds ratio [OR] 1.38, 95% confidence interval [CI] = 1.11-1.72) and prolonged length of hospital stay (mean difference = 2.09, 95% CI = 0.91-3.26). No significant association was observed between cancer cachexia and chemotherapy-related adverse events (OR = 1.42, 95% CI = 0.57-3.54). All pooled analyses showed considerable to substantial heterogeneity. No studies evaluating radiotherapy-related adverse events and only one study evaluating readmission met the inclusion criteria; therefore, these outcomes could not be quantitatively synthesized.

CONCLUSIONS

Cancer cachexia was associated with an increased risk of postoperative complications and prolonged length of hospital stay in patients with gastrointestinal cancers. However, because of the substantial heterogeneity and the very low certainty of the evidence, these findings should be interpreted with caution and cannot be considered definitive.