Association between between skeletal muscle mass and quality of life in adults with cancer: A systematic review and meta-analysis.

Abstract

Background: Low skeletal muscle mass (MM) is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health related quality of life (HRQOL) is less established. This systematic review and meta-analysis examines the relationship between skeletal MM and HRQOL in adults with cancer. Methods : Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, PsycInfo) were systematically searched to identify studies reporting on the association between computed tomography (CT) derived skeletal MM, and a validated measure of HRQOL in adults with cancer. Studies classifying skeletal MM as a categorical variable (low or normal) were combined in a meta-analysis to investigate cross-sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesised. Results : 14 studies involving 2,776 participants were eligible for inclusion. Participants were dichotomised according to low or normal skeletal MM in ten studies (n = 1,375); 58% had low MM. Low MM was associated with poorer global HRQOL scores (n = 985 from seven studies, standardised mean difference -0.27, 95% CI -0.40 to -0.14, P < 0.0001), and poorer physical functioning domain HRQOL scores (n = 507 from five studies, standardised mean difference -0.40, 95% CI -0.74 to -0.05, P = 0.02), but not social, role, emotional or cognitive functioning domain scores. Five studies examined the cross-sectional relationship between HRQOL and skeletal muscle mass as a continuous variable, and found little evidence of an association unless non-linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains.