Tan Haifeng, Gao Xiaoyu, Li Xiaoyu, Huang Yunling, Cao Qi, Wan Teng
Hengyang Medical College, University of South China, Hengyang, China.
Department of Spine Surgery, The Second Affiliated Hospital, University of South China, Hengyang, China.
Front Oncol. 2022 Apr 5;12:864501. doi: 10.3389/fonc.2022.864501. eCollection 2022.
As a metastasis cancer that happens up to 70% of the cancer patients, spinal metastasis is drawing attention for its significant impairment to health. There exist several predictive models designed to estimate mortality in spinal metastasis patients but they are reported with limited accuracy. In recent years, some retrospective cohort studies have been carried out to associate sarcopenia with mortality in spinal metastasis.
As a risk factor leading to adverse events in many diseases, sarcopenia was considered to significantly impact on patients with spinal metastasis in mortality by some scientists. We aimed to look through the current evidence and use statistic measures to value the role of sarcopenia in spinal metastasis. In this study, we are going to perform a systematic review and meta-analysis of available retrospective cohort studies where sarcopenia is assessed for outcomes in spinal metastasis patients.
On October 7, 2021, we performed a search in PubMed, Embase, and the Cochrane Library. We set no restrictions on language, date or areas. Results were expressed as hazard ratio (HR) or odds ratio (OR) with 95% CI by random effects model. Sensitivity analyses were performed to explore sources of heterogeneity and stability of results.
Of the 4,196 papers screened, 10 retrospective cohort studies were included, with a total of 1,674 patients. Results showed that sarcopenia was associated with higher overall mortality (OR, 1.60; 95% CI 1.35-1.90) and lower overall survival (HR, 2.08; 95% CI 1.55-2.80). The sensitivity analysis proved the stability of results in terms of publication years, region, time of diagnosis, sample size, female rate, measurement and follow up period.
Sarcopenia is a robust indicator of mortality in spinal metastasis patients and it might be applied to decision-making tools to assess survival probability and adjust the extent of treatment, while a lack of higher level of evidence is existing.
PROSPERO CRD42021283348.
脊柱转移作为一种在高达70%的癌症患者中发生的转移性癌症，因其对健康的严重损害而备受关注。存在几种旨在估计脊柱转移患者死亡率的预测模型，但据报道其准确性有限。近年来，一些回顾性队列研究已开展，以关联肌肉减少症与脊柱转移患者的死亡率。
作为导致许多疾病不良事件的一个风险因素，一些科学家认为肌肉减少症对脊柱转移患者的死亡率有显著影响。我们旨在梳理当前证据，并使用统计方法评估肌肉减少症在脊柱转移中的作用。在本研究中，我们将对评估肌肉减少症对脊柱转移患者结局影响的现有回顾性队列研究进行系统评价和荟萃分析。
2021年10月7日，我们在PubMed、Embase和Cochrane图书馆进行了检索。我们对语言、日期或领域没有限制。结果以随机效应模型的风险比（HR）或优势比（OR）及95%置信区间表示。进行敏感性分析以探索异质性来源和结果的稳定性。
在筛选的4196篇论文中，纳入了10项回顾性队列研究，共1674例患者。结果显示，肌肉减少症与较高的总死亡率（OR，1.60；95%CI 1.35 - 1.90）和较低的总生存率（HR，2.08；95%CI 1.55 - 2.80）相关。敏感性分析证明了结果在发表年份、地区、诊断时间、样本量、女性比例、测量方法和随访期方面的稳定性。
肌肉减少症是脊柱转移患者死亡率的一个可靠指标，它可能应用于决策工具以评估生存概率并调整治疗范围，同时存在缺乏更高水平证据的情况。
PROSPERO CRD42021283348
