Ozola Zalite I, Zykus R, Francisco Gonzalez M, Saygili F, Pukitis A, Gaujoux S, Charnley R M, Lyadov V
Pauls Stradins Clinical University Hospital, Riga, Latvia.
Hospital of Lithuanian University of Health Sciences Kaunas, Lithuania.
Pancreatology. 2015 Jan-Feb;15(1):19-24. doi: 10.1016/j.pan.2014.11.006. Epub 2014 Dec 4.
BACKGROUND/OBJECTIVES: Cachexia affects ∼ 80% of pancreatic cancer patients. An international consensus defines cachexia as an ongoing loss of skeletal muscle mass (sarcopenia) with or without loss of fat, which impairs body functioning and cannot be reversed by conventional nutritional measures. Weight loss percentage and elevated inflammation markers have been employed to define this condition earlier. This review aimed to assess the prevalence and consequences of cachexia and sarcopenia on survival in patients with pancreatic ductal adenocarcinoma.
The systematic review was performed by searching the articles with preset terms published in PubMed and Cochrane Database until December 2013. After identifying relevant titles, abstracts were read and eligible articles data retrieved on preformatted sheets. The prevalence and impact of sarcopenia/cachexia on survival was evaluated.
In total 1145 articles were retrieved, only 10 were eligible. Definitions of cachexia and sarcopenia were heterogeneous. In patients with normal weight (BMI 18.5-24.9 kg/m(2)) the prevalence of sarcopenia ranged from 29.7 to 65%. In overweight or obese patients (BMI >25 kg/m(2)) were 16.2%-67%. Sarcopenia alone was not demonstrated to be an independent factor of decreased survival, although obese sarcopenic patients were shown to have significantly worse survival in two studies.
Impact of cachexia and sarcopenia on survival in pancreatic ductal adenocarcinoma is currently understudied in the available literature. Definitive association between cachexia and survival cannot be drawn from available studies, although weight loss and sarcopenic obesity might be considered as poor prognostic factors. Further prospective trials utilizing the consensus definition of cachexia and including other confounding factors are needed to investigate the impact of cachexia and sarcopenia on survival in pancreatic adenocarcinoma.
背景/目的：恶病质影响约80%的胰腺癌患者。一项国际共识将恶病质定义为骨骼肌质量持续减少（肌肉减少症），伴有或不伴有脂肪减少，这会损害身体功能且无法通过传统营养措施逆转。体重减轻百分比和炎症标志物升高曾被用于更早地定义这种情况。本综述旨在评估恶病质和肌肉减少症对胰腺导管腺癌患者生存的患病率及影响。
通过检索在PubMed和Cochrane数据库中截至2013年12月发表的预设术语文章进行系统综述。确定相关标题后，阅读摘要并在预格式化表格上检索符合条件的文章数据。评估肌肉减少症/恶病质对生存的患病率及影响。
共检索到1145篇文章，仅10篇符合条件。恶病质和肌肉减少症的定义各不相同。体重正常（BMI 18.5 - 24.9 kg/m²）的患者中，肌肉减少症的患病率在29.7%至65%之间。超重或肥胖患者（BMI >25 kg/m²）中为16.2% - 67%。尽管在两项研究中显示肥胖的肌肉减少症患者生存明显更差，但仅肌肉减少症本身未被证明是生存降低的独立因素。
现有文献中目前对恶病质和肌肉减少症对胰腺导管腺癌患者生存的影响研究不足。尽管体重减轻和肌肉减少性肥胖可能被视为不良预后因素，但从现有研究中无法得出恶病质与生存之间的确切关联。需要进一步进行前瞻性试验，采用恶病质的共识定义并纳入其他混杂因素，以研究恶病质和肌肉减少症对胰腺腺癌患者生存的影响。
