Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York, USA.
Laryngoscope. 2021 Feb;131(2):333-341. doi: 10.1002/lary.28616. Epub 2020 Mar 27.
To determine whether radiologically defined sarcopenia at the C3 or L3 level as measured by computed tomography or magnetic resonance imaging is prognostic of overall survival (OS) in head and neck cancers (HNCs).
Literature searches of PubMed, Embase, and Scopus were conducted on July 12, 2019, to include articles written in the English language with no constraints on publication date. To be included in the analysis, articles had to report the prognostic impact of skeletal muscle mass measured radiologically at the C3 or L3 vertebral level in HNC patients; hazard ratios (HRs) for OS; 95% confidence intervals (CIs); be from a clinical trial, cohort, or case-control study; and have English full-text availability. Articles were reviewed in consensus by two reviewers, with disagreements reviewed by a third reviewer. Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis Of Observational Studies in Epidemiology Checklist guidelines were used for reporting. Study quality assessment was performed using Quality In Prognosis Studies tool. The random-effects DerSimonian and Laird method was used for meta-analysis.
Ten articles, nine retrospective and one prospective, were included in this meta-analysis (n = 2,181 patients). Significant differences were found in OS for HNC patients with sarcopenia (HR = 1.98; 95% CI: 1.64-2.39; P < .00001). No heterogeneity was detected in either the overall or subgroup analyses.
Radiologically defined sarcopenia is a negative predictor of OS in patients with HNC. Early detection of sarcopenia in cancer patients may help guide nutritional and adjuvant support to improve treatment outcomes.
NA Laryngoscope, 131:333-341, 2021.
通过计算机断层扫描或磁共振成像测量 C3 或 L3 水平的影像学定义的骨骼肌减少症，确定其是否对头颈癌（HNC）患者的总生存率（OS）具有预后意义。
于 2019 年 7 月 12 日对 PubMed、Embase 和 Scopus 进行文献检索，纳入文献语言为英文且无发表日期限制。分析纳入的文章必须报告在 HNC 患者中通过影像学测量 C3 或 L3 椎体水平的骨骼肌量的预后影响；总生存率（OS）的危险比（HR）；95%置信区间（CI）；必须来自临床试验、队列研究或病例对照研究；且有英文全文可获得。两名评审员以共识的方式审查文章，如果存在分歧，则由第三名评审员进行审查。采用系统评价和荟萃分析的首选报告项目以及观察性研究的荟萃分析流行病学清单指南进行报告。使用质量预后研究工具进行研究质量评估。使用随机效应 DerSimonian 和 Laird 方法进行荟萃分析。
这项荟萃分析纳入了 10 篇文章，9 篇为回顾性研究，1 篇为前瞻性研究（n = 2181 例患者）。患有骨骼肌减少症的 HNC 患者的 OS 存在显著差异（HR = 1.98；95%CI：1.64-2.39；P < .00001）。无论是在整体分析还是亚组分析中，均未检测到异质性。
影像学定义的骨骼肌减少症是 HNC 患者 OS 的负面预测因子。在癌症患者中早期发现骨骼肌减少症可能有助于指导营养和辅助支持，以改善治疗结局。
无 喉镜，131：333-341，2021。
