West China School of Medicine/West China Hospital, Sichuan University, Chengdu, 610041, PR China.
Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041, PR China.
Eur J Surg Oncol. 2019 May;45(5):747-754. doi: 10.1016/j.ejso.2019.03.003. Epub 2019 Mar 7.
Sarcopenia is associated with unfavorable prognosis in patients undergoing surgical treatments of the respiratory tract, gastrointestinal tract and urinary tracts. We summarized all available evidence to investigate the prognostic value of sarcopenia in patients with surgically treated urothelial carcinoma (UC).
We conducted a comprehensive study search up to January 2019, searching the online database Embase, PubMed and Cochrane Library. The hazard ratio (HR) and 95% confidence interval (CI) were extracted from the studies.
A total of 12 research consisting of 2075 patients were enrolled in the quantitative synthesis. We observed that UC patients with sarcopenia had a worse OS (HR = 1.87; 95%CI 1.43-2.45; P < 0.001) and CSS (HR = 1.98; 95%CI 1.43-2.75; P < 0.001). Stratified by tumor, sarcopenia is also an unfavorable factor for OS and CSS in patients with upper tract urothelial carcinoma (UTUC) or urothelial carcinoma of bladder (UCB).
Sarcopenia is an unfavorable factor for OS and CSS in patients with surgically treated UC. Besides, stratified by tumor, the results of patients with UTUC or UCB are consistent with previous results. More prospective studies are required to validate our findings.
肌少症与接受呼吸道、胃肠道和泌尿道手术治疗的患者的不良预后相关。我们总结了所有现有证据，以研究肌少症在接受手术治疗的尿路上皮癌（UC）患者中的预后价值。
我们进行了全面的文献检索，检索截至 2019 年 1 月的 Embase、PubMed 和 Cochrane Library 在线数据库。从研究中提取了风险比（HR）和 95%置信区间（CI）。
共纳入了 12 项研究，共 2075 例患者进行了定量综合分析。我们发现，患有肌少症的 UC 患者的总生存期（OS）（HR=1.87；95%CI 1.43-2.45；P<0.001）和无进展生存期（CSS）（HR=1.98；95%CI 1.43-2.75；P<0.001）更差。按肿瘤分层，肌少症也是上尿路尿路上皮癌（UTUC）或膀胱癌（UCB）患者 OS 和 CSS 的不利因素。
肌少症是接受手术治疗的 UC 患者 OS 和 CSS 的不利因素。此外，按肿瘤分层，UTUC 或 UCB 患者的结果与之前的结果一致。需要更多的前瞻性研究来验证我们的发现。
