Association between cancer cachexia and treatment-related adverse outcomes in patients with gastrointestinal cancers: a systematic review and meta-analysis.
Naohiro Furuya, Takuya Yanagisawa, Noriatsu Tatematsu et al.
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In 30 seconds
This systematic review and meta-analysis examined cohort studies of cancer cachexia and treatment-related outcomes in patients with gastrointestinal cancers. Across 34 studies involving 27,473 participants, cachexia was associated with higher odds of postoperative complications (OR 1.38, 95% CI = 1.11-1.72) and a longer hospital stay (mean difference = 2.09, 95% CI = 0.91-3.26). No significant association with chemotherapy-related adverse events was found. The authors noted considerable to substantial heterogeneity and very low certainty of evidence, so the findings are not definitive.
Key findings
- Cachexia was associated with higher odds of postoperative complications (OR 1.38, 95% CI = 1.11-1.72).
- Cachexia was associated with a longer hospital stay (mean difference = 2.09, 95% CI = 0.91-3.26).
- No significant association was observed with chemotherapy-related adverse events (OR = 1.42, 95% CI = 0.57-3.54).
- Radiotherapy outcomes could not be pooled; only one eligible study assessed readmission.
Why it matters
The findings suggest that cachexia may identify patients with gastrointestinal cancers who are more likely to experience postoperative complications or prolonged hospitalization. This association can inform clinical awareness of nutritional status when considering treatment-related risks, but substantial heterogeneity and very low certainty mean the estimates should not be treated as definitive.
What to keep in mind
The evidence was based on cohort studies, with considerable to substantial heterogeneity and very low certainty. Radiotherapy outcomes were not represented, and readmission evidence was limited to one study.