Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Nutrition. 2022 Sep;101:111704. doi: 10.1016/j.nut.2022.111704. Epub 2022 Apr 22.
The aim of this study was to conduct a systematic review and meta-analysis of observational studies to estimate the overall prevalence and prognostic value of sarcopenic obesity (SO) in patients with cancer. We searched PubMed, Embase, Web of Science and the Cochrane Library for observational studies reporting the prevalence of SO and its prognosis in patients with cancer from inception to December 2020. The pooled prevalence, hazard ratios (HRs), odds ratios (ORs) and their 95% confidence intervals (CIs) of data extracted from the studies were calculated. We included 10 004 patients with cancer from 38 studies. The pooled prevalence of SO in this group of patients was 20% (95% CI, 17%-24%). Meta-analysis showed SO was significantly associated with poor overall survival (HR, 1.83; 95% CI, 1.41-2.38), recurrence-free survival (HR, 2.10; 95% CI, 1.57-2.80), disease-free survival (HR, 1.94; 95% CI, 1.01-3.74), postoperative complications (OR, 3.01; 95% CI, 2.08-4.33), and prolonged hospital length of stay (OR, 5.69; 95% CI, 2.76-11.74). The results for the relationship between SO and chemotherapy toxicity were inconsistent and controversial. Current limited evidence suggested that SO may be associated with poor cancer-specific survival (HR, 5.00; 95% CI, 1.40-16.70), but not progression-free survival (HR, 0.61; 95% CI, 0.32-1.16). The present review indicated SO is common in patients with cancer and is significantly associated with several poor outcomes. Therefore, it is necessary to diagnose and screen for SO in patients with cancer in the future, and appropriate interventions should be further explored to improve the prognosis of cancer patients.
本研究旨在对观察性研究进行系统回顾和荟萃分析，以评估癌症患者中肌肉减少性肥胖（SO）的总体患病率及其预后价值。我们检索了 PubMed、Embase、Web of Science 和 Cochrane Library，以获取从研究开始到 2020 年 12 月期间报告癌症患者 SO 患病率及其预后的观察性研究。从研究中提取的数据的汇总患病率、风险比（HRs）、优势比（ORs）及其 95%置信区间（CIs）进行了计算。我们纳入了 38 项研究中的 10004 名癌症患者。这组患者中 SO 的汇总患病率为 20%（95%CI，17%-24%）。荟萃分析显示，SO 与总体生存不良显著相关（HR，1.83；95%CI，1.41-2.38）、无复发生存（HR，2.10；95%CI，1.57-2.80）、无病生存（HR，1.94；95%CI，1.01-3.74）、术后并发症（OR，3.01；95%CI，2.08-4.33）和住院时间延长（OR，5.69；95%CI，2.76-11.74）。SO 与化疗毒性之间的关系的结果不一致且存在争议。目前有限的证据表明，SO 可能与癌症特异性生存不良相关（HR，5.00；95%CI，1.40-16.70），但与无进展生存无关（HR，0.61；95%CI，0.32-1.16）。本综述表明，SO 在癌症患者中较为常见，且与多种不良结局显著相关。因此，未来有必要在癌症患者中诊断和筛查 SO，并进一步探索适当的干预措施，以改善癌症患者的预后。
