Prevalence and survival implications of CT-defined low skeletal muscle mass in lung cancer: a systematic review and meta-analysis.

Abstract

<h4>Objective</h4>To systematically evaluate the prevalence of low skeletal muscle mass(LSMM) and its associations with survival outcomes in patients with lung cancer.<h4>Methods</h4>A comprehensive and systematic literature search was conducted across multiple electronic databases, including the China National Knowledge Infrastructure (CNKI), Wanfang Data, the Chinese Biomedical Literature Database (CBM), VIP Database, PubMed, EMBASE, Web of Science, and the Cochrane Library. Eligible studies were screened according to predefined inclusion and exclusion criteria. The methodological quality and risk of bias of the included studies were independently assessed by two reviewers using the Newcastle-Ottawa Scale (NOS). All statistical analyses were performed using STATA software (version 18.0).<h4>Results</h4>A total of 29 studies were included. Meta-analysis results showed an overall prevalence of 40% (95% CI, 33% to 46%) and an association between LSMM and shorter overall survival (OS) in lung cancer patients (HR = 1.84 (95% CI: 1.47-2.32) and recurrence-free survival (RFS) (HR = 1.90, 95% CI: 1.50-2.40). Leave-one-out sensitivity analyses indicated that the pooled OS estimate remained stable. Publication bias Egger linear regression analysis showed no publication bias between studies.<h4>Conclusions</h4>LSMM is common in lung cancer patients, affecting about 43% of patients, most notably in Asian countries. LSMM is an important predictor of shorter OS in patients with SCLC or NSCLC. More prospective studies are needed to explore the association between LSMM and DFS, PFS, and CCS in patients with different types of lung cancer.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261291196.