Prevalence of Sarcopenia Determined by Computed Tomography in Pancreatic Cancer: A Systematic Review and Meta-Analysis of Observational Studies.

Simple Summary: Sarcopenia, a condition where muscle mass decreases, is linked to worse outcomes in pancreatic cancer patients. Computed tomography scans, which are routinely used to monitor these patients, offer a chance to assess sarcopenia without additional procedures. However, different studies report varying rates of sarcopenia due to the use of different measurement methods and thresholds. This variability can affect conclusions regarding patient outcomes, such as overall or progression-free survival. In this study, we found that sarcopenia affects nearly half of pancreatic cancer patients, with higher rates in those with advanced stages of the disease. The prevalence varied depending on the measurement methods used. These findings highlight the need to standardize how sarcopenia is assessed in future studies, which may improve clinical decision making and patient care. Introduction: Sarcopenia, a condition characterized by a loss of skeletal muscle mass, is increasingly recognized as a significant factor influencing patient outcomes in pancreatic cancer (PC). This systematic review and meta-analysis aimed to estimate the prevalence of sarcopenia in patients with PC using computed tomography and to explore how different measurement methods and cut-off values impact such prevalence. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search of PubMed, Web of Science, and EMBASE databases was performed, identifying 48 observational studies involving 9063 patients. Results: The overall pooled prevalence of sarcopenia was 45% (95% CI, 40–50%), but varied significantly by the method used: 47% when measured with the skeletal muscle index and 33% when assessed with the total psoas area. In addition, in studies using SMI, sarcopenia prevalence was 19%, 45%, and 57% for cutoff values <40 cm2/m2, 40–50 cm2/m2, and >50 cm2/m2, respectively. Moreover, the prevalence was higher in patients receiving palliative care (50%) compared to those treated with curative intent (41%). High heterogeneity was observed across all analyses, underscoring the need for standardized criteria in sarcopenia assessment. Conclusions: Our findings highlight the substantial variability in sarcopenia prevalence, which could influence patient outcomes, and stress the importance of consensus in measurement techniques to improve clinical decision making and research comparability. [ABSTRACT FROM AUTHOR]