心肺适能与成年人癌症诊断后全因死亡率：系统评价和荟萃分析。
Cardiorespiratory fitness and all-cause mortality in adults diagnosed with cancer systematic review and meta-analysis.
机构信息
Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, Universitat de València, Valencia, Spain.
Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
出版信息
Scand J Med Sci Sports. 2021 Sep;31(9):1745-1752. doi: 10.1111/sms.13980. Epub 2021 May 14.
INTRODUCTION
The inverse association between cardiorespiratory fitness and all-cause mortality in apparently healthy populations has been previously reported; however, the existence of this association among adults diagnosed with cancer is unclear.
AIM
To determine the association between cardiorespiratory fitness and all-cause mortality in adults diagnosed with cancer.
METHODS
Medline, Embase, and SPORTDiscus databases were searched. Eligible prospective cohort studies that examined the association of cardiorespiratory fitness with all-cause mortality in adults diagnosed with cancer were included. Hazard ratios (HRs) with associated 95% confidence intervals (CIs) were extracted from studies for all-cause mortality and pooled HRs were calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment.
RESULTS
Data from 13 studies with 6,486 adults were included. Compared with lower levels of cardiorespiratory fitness, high levels were associated with a reduced risk of all-cause mortality among adults diagnosed with any cancer (HR = 0.52; 95% CI, 0.35-0.77), lung cancer (HR = 0.62; 95% CI, 0.46-0.83), and among those with cardiorespiratory fitness measurement via indirect calorimetry (HR = 0.47; 95% CI, 0.27-0.80). Pooled HRs for the reduction in all-cause mortality risk per 1-MET increase were also statistically significant (HR = 0.82; 95% CI, 0.69-0.99). Neither age at baseline nor the length of follow-up had a significant influence on the HR estimates for all-cause mortality risk.
CONCLUSION
Cardiorespiratory fitness may confer an independent protective benefit against all-cause mortality in adults diagnosed with cancer. The use of cardiorespiratory fitness as a prognostic parameter might help determine risk for future adverse clinical events and optimize therapeutic management strategies to reduce long-term treatment-related effects in adults diagnosed with cancer.
简介
在看似健康的人群中，心肺功能与全因死亡率之间呈负相关关系，这已得到先前的报道；然而，在被诊断患有癌症的成年人中，这种相关性是否存在尚不清楚。
目的
确定被诊断患有癌症的成年人的心肺功能与全因死亡率之间的关系。
方法
检索了 Medline、Embase 和 SPORTDiscus 数据库。纳入了检查被诊断患有癌症的成年人的心肺功能与全因死亡率之间关联的前瞻性队列研究。使用随机效应逆方差模型和 Hartung-Knapp-Sidik-Jonkman 调整，从研究中提取全因死亡率的风险比（HR）及其相关的 95%置信区间（CI），并计算合并 HR。
结果
纳入了 13 项研究，共有 6486 名成年人的数据。与较低水平的心肺功能相比，较高水平的心肺功能与被诊断患有任何癌症（HR=0.52；95%CI，0.35-0.77）、肺癌（HR=0.62；95%CI，0.46-0.83）以及通过间接热量法测量心肺功能的成年人（HR=0.47；95%CI，0.27-0.80）的全因死亡率降低相关。每增加 1 个梅脱心肺功能的全因死亡率降低风险的合并 HR 也具有统计学意义（HR=0.82；95%CI，0.69-0.99）。基线时的年龄和随访时间均对全因死亡率风险的 HR 估计值没有显著影响。
结论
心肺功能可能为被诊断患有癌症的成年人提供独立的全因死亡率保护益处。将心肺功能用作预后参数可能有助于确定未来不良临床事件的风险，并优化治疗管理策略，以降低被诊断患有癌症的成年人的长期治疗相关影响。
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