Abstract: Objective To investigate the predictive effects of sarcopenia on the prognosis of prostate cancer after comprehensive treatment and its value. Methods Literature data on the association between prostate cancer and sarcopenia up to October 2023 were retrieved from Pubmed and Embase databases. Literature screening, data extraction and quality evaluation were conducted according to the inclusion and exclusion criteria. Stata 9.0 software (Stata Corporation, USA) was used for the Meta⁃analysis to evaluate the incidence of sarcopenia and its effect on the overall survival (OS) and progression⁃free survival (PFS) outcomes of prostate cancer. Results A total of 1,854 prostate cancer patients were included in 10 studies. Meta⁃analysis showed that the incidence of sarcopenia in prostate cancer was 60% (95%CI: 48%-72%). Subgroup analysis with different treatments modalities showed that the incidence of sarcopenia was 48% (95%CI: 28%-67%) in prostate cancer patients treated with chemotherapy/endocrine therapy and 77% (95%CI: 64%-89%) in the endocrine therapy group, and the incidence of sarcopenia in the other groups was 64% (95%CI: 45%-82%). Subgroup analysis of different types of prostate cancer showed that the incidence of sarcopenia was 64% (95%CI: 47%-80%) in the castration resistant prostate cancer group and 58% (95%CI: 0.37-0.79) in the metastatic prostate cancer group. Sarcopenia significantly shortened the OS (HR=1.53, 95%CI: 1.00-2.33) in patients with metastatic prostate cancer and PFS (HR=2.09, 95%CI: 1.21-3.61) in patients with chemotherapy/endocrine therapy for prostate cancer. Conclusions The incidence of sarcopenia is high in prostate cancer, and can shorten the prognosis after prostate cancer treatment, especially for metastatic prostate cancer and the patients receiving chemotherapy and endocrine therapy, though large⁃size samples are needed for verification.

Key words: Prostate cancer, Sarcopenia, Incidence, Overall survival, Progression-free survival