BACKGROUND: Sarcopenia has emerged as a potential prognostic factor in patients with advanced prostate cancer (PCa), requiring interventions for its prevention and treatment. OBJECTIVE: We aimed to systematically identify, critically assess and synthesize the available evidence on the effectiveness and safety of interventions for preventing or treating sarcopenia in advanced PCa patients. METHODS: MEDLINE, Embase and Web of Science were searched. Randomized and non-randomized controlled trials or longitudinal observational studies with a control group focusing on PCa patients aged 60 years and older were considered. Study selection, data extraction and risk-of-bias assessment of the included studies were performed in duplicate. When possible, pooled effect estimates were calculated. RESULTS: Twenty studies (n = 1275) were included. Resistance training (RT) (MD = 3.22 kg; 95% CI 0.69, 5.75) and the use of antimyostatin peptibody (MD = 2.2 kg; SE 0.8%) demonstrated statistically significant prevention of lean body mass loss in men undergoing androgen deprivation therapy (ADT). Exercise improved leg press (MD = 25.17 kg; 95% CI 8.71, 41.62), leg extension (MD = 9.63 kg; 95% CI 4.83, 14.42), seated row (MD = 4.38 kg; 95% CI 1.54, 7.22) and chest press strength (MD = 1.70 kg; 95% CI -1.48, 4.88) and enhanced patients' physical functioning in chair sit-to-stand tests (MD = -1.02 kg; 95% CI -1.70, -0.34). RT improved health-related quality of life (HRQoL) in both general and specific domains and also reduced somatization (MD = -0.69 kg; 95% CI -1.32, -0.07) and psychological distress (MD = -1.63 kg; 95% CI -3.10, -0.15). CONCLUSIONS: The findings highlight the potential benefits of RT and selected pharmacological interventions on muscle-related and functional outcomes. However, the significant heterogeneity and lack of comprehensive outcome reporting underscore the need for more standardized and long-term research through larger, well-designed randomized controlled trials with standardized measurement methods to draw conclusive evidence and enhance the reliability and applicability of findings in clinical practice.
Pablos‐Rodríguez et al. (Tue,) studied this question.