Deng Han-Yu, Zha Panpan, Hou Liang, Huang Kai-Li
Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Interact Cardiovasc Thorac Surg. 2019 Jul 1;29(1):144-147. doi: 10.1093/icvts/ivz039.
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does sarcopenia have any impact on survival of patients with surgically treated non-small-cell lung cancer (NSCLC)?'. Altogether, 342 papers were found using the reported search, of which 9 cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Eight of the studies measured skeletal muscle or total psoas cross-sectional area at the level of the first or third lumbar vertebra normalized for the square of height for defining sarcopenia, while 1 study used absolute measurement of total psoas cross-sectional area. Seven of 8 studies looking at overall survival found that patients with sarcopenia had significantly worse overall survival than those without after surgical resection of NSCLC, while 1 failed to show a difference. Five studies reported disease-free survival, with 3 studies showing no difference and 2 showing that patients with sarcopenia had a significantly worse disease-free survival than those without. One study found that sarcopenia was a predictor of early recurrence in NSCLC patient after surgical resection. Therefore, we conclude that sarcopenia could serve as a predictor of poor prognosis of patients with surgically treated NSCLC.
根据结构化方案撰写了一篇胸外科最佳证据主题文章。所探讨的问题是“肌肉减少症对接受手术治疗的非小细胞肺癌（NSCLC）患者的生存有何影响？”。通过报告的检索共找到342篇论文，其中9项队列研究代表了回答该临床问题的最佳证据。这些论文的作者、期刊、发表日期和国家、所研究的患者组、研究类型、相关结局和结果均列于表格中。8项研究中有7项通过测量第一或第三腰椎水平的骨骼肌或总腰大肌横截面积并按身高平方进行标准化来定义肌肉减少症，而1项研究使用了总腰大肌横截面积的绝对测量值。在8项关注总生存的研究中，有7项发现肌肉减少症患者在接受NSCLC手术切除后的总生存明显差于无肌肉减少症的患者，而1项未显示出差异。5项研究报告了无病生存情况，其中3项研究显示无差异，2项研究表明肌肉减少症患者的无病生存明显差于无肌肉减少症的患者。1项研究发现肌肉减少症是NSCLC患者手术切除后早期复发的预测因素。因此，我们得出结论，肌肉减少症可作为接受手术治疗的NSCLC患者预后不良的预测指标。
