West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China.
Int Braz J Urol. 2020 Sep-Oct;46(5):705-715. doi: 10.1590/S1677-5538.IBJU.2019.0636.
Sarcopenia, a concept reflecting the loss of skeletal muscle mass, was reported to be associated with the prognosis of several tumors. However, the prognostic value of sarcopenia in patients with renal cancer remains unclear. We carried out this meta-analysis and systematic review to evaluate the prognostic value of sarcopenia in patients with renal cell carcinomas. We comprehensively searched PubMed, Embase, and Cochrane Library from inception to December 2018. Hazard ratio (HR) and 95% confidence interval (CI) were pooled together. A total of 5 studies consisting of 771 patients were enrolled in this quantitative analysis, 347 (45.0%) of which had sarcopenia. Patients with sarcopenia had a worse OS compared with those without sarcopenia (HR=1.76; 95%CI, 1.35-2.31; P<0.001). In the subgroup of patients with localized and advanced/metastatic diseases, sarcopenia was also associated with poor OS (HR=1.48, P=0.039; HR=2.14, P<0.001; respectively). With a limited sample size, we did not observe difference of PFS between two groups (HR=1.56, 95% CI, 0.69-3.50, P=0.282). In the present meta-analysis, we observed that patients with sarcopenia had a worse OS compared with those without sarcopenia in RCC. Larger, preferably prospective studies, are needed to confirm and update our findings.
肌肉减少症是一种反映骨骼肌质量损失的概念，据报道与几种肿瘤的预后有关。然而，肌肉减少症在肾癌患者中的预后价值尚不清楚。我们进行了这项荟萃分析和系统评价，以评估肌肉减少症在肾细胞癌患者中的预后价值。我们全面检索了 PubMed、Embase 和 Cochrane Library 从成立到 2018 年 12 月。风险比（HR）和 95%置信区间（CI）合并在一起。共有 5 项研究纳入了这项定量分析，共 771 例患者，其中 347 例（45.0%）患有肌肉减少症。患有肌肉减少症的患者的总生存期（OS）比没有肌肉减少症的患者差（HR=1.76；95%CI，1.35-2.31；P<0.001）。在局限性和晚期/转移性疾病的患者亚组中，肌肉减少症也与较差的 OS 相关（HR=1.48，P=0.039；HR=2.14，P<0.001；分别）。由于样本量有限，我们没有观察到两组之间的无进展生存期（PFS）差异（HR=1.56，95%CI，0.69-3.50，P=0.282）。在本荟萃分析中，我们观察到患有肌肉减少症的 RCC 患者的 OS 比没有肌肉减少症的患者差。需要更大、最好是前瞻性的研究来证实和更新我们的发现。
