Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
J Cachexia Sarcopenia Muscle. 2019 Dec;10(6):1165-1174. doi: 10.1002/jcsm.12468. Epub 2019 Aug 7.
Sarcopenia is the loss of skeletal muscle mass and function that occurs with advancing age and certain diseases. It is thought to have a negative impact on survival in cancer patients. Routine computed tomography imaging is often used to quantify skeletal muscle in cancer patients. Sarcopenia is defined by a low skeletal muscle index (SMI). Skeletal muscle radiation attenuation (SMRA) is used to define muscle quality. The primary aim of this meta-analysis was to study the association between sarcopenia or SMRA and overall survival (OS) or complications in patients with ovarian cancer.
Medline, Embase, CINAHL, and PEDro databases were searched from inception to 15 February 2019. Studies evaluating the prognostic effect of SMI and SMRA on ovarian cancer survival or surgical complications were included. Risk of bias and study quality were evaluated with the Quality in Prognosis Studies Instrument (QUIPS) according to the modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.
The search strategy yielded 4262 hits in all four databases combined. Ten and eight studies were included for qualitative and quantitative analysis, respectively. Meta-analysis revealed a significant association between the SMI and OS [0.007; hazard ratio (HR): 1.11, 95% confidence interval (CI): 1.03-1.20]. SMRA was also significantly associated with OS (P < 0.001; HR: 1.14, 95% CI: 1.08-1.20). Association between the SMI and surgical complications had borderline statistical significance (0.05; HR: 1.23, 95% CI: 1.00-1.52). The risk of bias assessed with QUIPS was high in all studies. The quality of the evidence was very low.
Whereas our meta-analysis indicated that a low SMI and low SMRA are associated with survival in ovarian cancer patients, the low quality of the source data precludes drawing definitive conclusions.
随着年龄的增长和某些疾病的发生，骨骼肌质量和功能的丧失被称为肌肉减少症。据认为，它对癌症患者的生存有负面影响。常规的计算机断层扫描成像常用于量化癌症患者的骨骼肌。肌肉减少症通过低骨骼肌指数（SMI）来定义。骨骼肌辐射衰减（SMRA）用于定义肌肉质量。本次荟萃分析的主要目的是研究肌肉减少症或 SMRA 与卵巢癌患者的总生存（OS）或并发症之间的关系。
从建库到 2019 年 2 月 15 日，检索了 Medline、Embase、CINAHL 和 PEDro 数据库。纳入评估 SMI 和 SMRA 对卵巢癌生存或手术并发症预后影响的研究。根据改良的推荐评估、制定与评估（GRADE）框架中的质量预后研究工具（QUIPS）评估风险偏倚和研究质量。
在所有四个数据库中，搜索策略共产生了 4262 个结果。有 10 项和 8 项研究分别用于定性和定量分析。荟萃分析显示，SMI 与 OS 之间存在显著关联[0.007；风险比（HR）：1.11，95%置信区间（CI）：1.03-1.20]。SMRA 与 OS 也有显著关联（P < 0.001；HR：1.14，95% CI：1.08-1.20）。SMI 与手术并发症之间的关联具有统计学意义（0.05；HR：1.23，95% CI：1.00-1.52）。QUIPS 评估的所有研究的偏倚风险均较高。证据质量非常低。
尽管我们的荟萃分析表明低 SMI 和低 SMRA 与卵巢癌患者的生存有关，但原始数据质量低，无法得出明确结论。
