Professorial Surgical Unit, Trinity College Dublin, Trinity Centre for Health Science, Dublin, Ireland.
National Surgical Centre for Pancreatic Cancer, St Vincent's University Hospital, Dublin, Ireland.
Dig Surg. 2022;39(4):141-152. doi: 10.1159/000524575. Epub 2022 May 17.
BACKGROUND/OBJECTIVES: Sarcopenia in pancreatic cancer may increase the risk of chemotherapy-related toxicity and post-operative morbidity. This systematic review and meta-analysis aimed to quantify the prevalence of sarcopenia in early stage pancreatic cancer.
Relevant studies were identified using Ovid Medline and Elsevier Embase. Pooled estimates of prevalence rates (percentages) and corresponding 95% confidence interval (CI) were computed using a random-effects model to allow for heterogeneity between studies.
The majority of the 33 studies (n = 5,593 patients) included in this meta-analysis utilized computed tomography (CT)-derived measures for body composition assessment in patients undergoing pancreatic resection. Reported prevalence of sarcopenia varied between 14 and 74%, and the pooled prevalence was 39% (95% CI: 38-40%) Heterogeneity was considerable, however, (I2 = 93%) and did not improve significantly when controlling for assessment method, and use of pre-defined cut-offs for sarcopenia, limiting potential to evaluate the true impact of sarcopenia.
The ready availability of sequential CT offers a valuable opportunity for body composition assessment, but the quality of assessment and interpretation must improve before the impact of body composition on treatment-related outcomes and survival can be assessed. We suggest recommendations for the assessment of body composition for the design of future studies.
背景/目的：胰腺癌患者的肌肉减少症可能会增加化疗相关毒性和术后发病率的风险。本系统评价和荟萃分析旨在量化早期胰腺癌中肌肉减少症的患病率。
使用 Ovid Medline 和 Elsevier Embase 检索相关研究。使用随机效应模型计算患病率（百分比）和相应的 95%置信区间（CI）的汇总估计值，以允许研究之间存在异质性。
本荟萃分析纳入的 33 项研究（n=5593 例患者）中，大多数研究都使用计算机断层扫描（CT）评估胰腺癌切除术患者的身体成分。报告的肌肉减少症患病率在 14%至 74%之间，汇总患病率为 39%（95%CI：38-40%）。然而，异质性很大（I2=93%），并且当控制评估方法和使用肌肉减少症的预定义截止值时，异质性并没有显著改善，限制了评估肌肉减少症对治疗相关结局和生存影响的能力。
连续 CT 的广泛应用为身体成分评估提供了有价值的机会，但在评估身体成分对治疗相关结局和生存的影响之前，评估和解释的质量必须提高。我们建议了评估身体成分的建议，以设计未来的研究。
