Ultrasound for skeletal muscle assessment in surgical oncology: A scoping review

Abstract

Background: Skeletal muscle wasting in cancer patients is associated with adverse outcomes. Ultrasound offers a non-invasive muscle assessment, but no previous review has focused on its application during perioperative period. This scoping review aims to map the current literature on the ultrasound use for skeletal muscle assessment in cancer patients during the perioperative period and identify knowledge gaps for future research. Methods: A systematic literature search was conducted in the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Embase, Medline, and Web of Science. Two independent reviewers screened studies for eligibility and extracted relevant data, including study characteristics, population, ultrasound protocols, and outcomes. Inclusion criteria were primary studies involving adults undergoing cancer surgery with ultrasound used for skeletal muscle assessment during the perioperative period. Results: Thirteen studies were included. The majority assessed quantitative parameters, with the rectus femoris muscle being the most evaluated. Muscle thickness and cross-sectional area were the most frequently reported parameters. Studies validated ultrasound parameters against established tools and clinical indicators, including sarcopenia, frailty, muscle strength, and biomarker. Ultrasound was also used to predict postoperative outcomes and assess perioperative interventions. However, variability in ultrasound protocols highlights the need for standardized practices, and the lack of consensus on cutoffs warrants future research. Conclusions: This review demonstrated the validity and the applications of ultrasound for skeletal muscle assessment in cancer patients during the perioperative period. Significant variability in ultrasound protocols and the absence of standardized cutoffs highlight the need for further research.