Prognostic Effects of Sarcopenia on Patients with Bladder Cancer: A Systematic Review and Meta-Analysis

Sarcopenia can negatively impact the survival of cancer patients. This study intends to delve into the correlation of sarcopenia with survival and complications in patients with bladder cancer (BC) after surgery. Web of Science, Cochrane Library, Embase, and PubMed databases were retrieved up to April 7, 2023, to collect studies on the impact of sarcopenia on the prognosis of adults with BC. Primary outcomes encompassed overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). The secondary outcome consisted of postoperative complications. A meta-analysis was conducted using Stata. Forest plots and summary effect models were employed to present the results. The quality of eligible studies was assessed using the Newcastle-Ottawa Scale (NOS). Initially, 1713 studies were identified through searches across four databases, and 26 studies were ultimately included in the analysis. Sarcopenia was significantly associated with OS (HR:1.62; 95% CI: 1.43-1.83; P < 0.001, I-2 = 0.9%), CSS (HR: 1.81, 95% CI: 1.52-2.15, P < 0.001, I-2 = 0.0%), and RFS (HR: 1.76, 95% CI: 1.21-2.56, P = 0.003, I-2 = 0.0%) in BC patients. Subgroup analyses revealed that sarcopenia is strongly linked to prognosis and postoperative complications in BC patients.