Sarcopenia among older patients with cancer: A scoping review of the literature

In the older patients with cancer, the combination of aging and cancer makes sarcopenia more likely to occur. However, previous studies paid less attention to the sarcopenia of older patients with cancer. To address these gaps, we conducted a scoped review of the prevalence, measurement, prognostic value, and clinical interventions of sarcopenia in this population. A comprehensive search of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Embase, China National Knowledge Infrastructure (CNKI) and Wangfang electronic databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Two independent reviewers screened all abstracts and full-text studies for inclusion. We identified 10,850 studies, and 39 met the inclusion criteria. Two reviewers extracted data on study characteristics, study design, measuring tools and main outcomes. This review included works from 11 countries. All studies were quantitative and most used a cross-sectional (n = 17) or retrospective (n = 16) design. The prevalence of sarcopenia in elderly cancer survivors ranged from 18.5% to 83%, and skeletal muscle mass index (SMI) by computed tomography (CT) scan at lumbar 3 (L3) was the most commonly used way to define sarcopenia. Meanwhile, pre-therapeutic sarcopenia was significantly related to postoperative complications, lower overall survival and impaired physical function. This review emphasizes sarcopenia is highly prevalent in older patients with cancer, which leads to poor outcomes and urgently needs attention from nutritionists, surgeons, oncologists, psychologists and nurses.