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肌内脂肪浸润对胃癌患者总生存预后价值的荟萃分析:一项试验序贯分析。

Prognostic values of myosteatosis for overall survival in patients with gastric cancers: A meta-analysis with trial sequential analysis.

机构信息

Department of Anesthesiology, First Affiliated Hospital of China Medical University, Shenyang, China.

University of Texas Health Science Center at Houston, Houston, Texas, USA.

出版信息

Nutrition. 2023 Jan;105:111866. doi: 10.1016/j.nut.2022.111866. Epub 2022 Oct 14.

Abstract

OBJECTIVES

Gastric cancer is among the most common and lethal cancers worldwide. Recently, studies have reported that myosteatosis is a prognosticator for adverse survival outcomes in patients with gastric cancer, but with inconsistent conclusions. Therefore, this meta-analysis aimed to systematically quantify the predictive power of myosteatosis for overall survival in the gastric cancer setting.

METHODS

A systematic literature earch was conducted based on three databases (PubMed/Medline, EMBASE, and Web of Science) from inception until November 30, 2021. This meta-analysis pooled the hazard ratios and their 95% confidence intervals of mortality risk in patients with gastric cancer with myosteatosis versus nonmyosteatosis using a fixed-effects model.

RESULTS

Twelve studies of 5904 patients were included. Myosteatosis was associated with higher mortality risk (hazard ratio: 1.46; 95% confidence interval, 1.32-1.61; P < 0.001; I = 23.8%) in the gastric cancer setting. The results of the subgroup analysis revealed that patients with myosteatosis undergoing surgery had significantly shortened overall survival. Overall, the results of this meta-analysis are robust to sensitivity and trial sequential analyses.

CONCLUSIONS

Myosteatosis was identified as a strong predictor of reduced overall survival in the gastric cancer population.

摘要

目的

胃癌是全球最常见和最致命的癌症之一。最近的研究报告称,肌肉减少症是预测胃癌患者不良生存结局的指标,但结论不一致。因此,本荟萃分析旨在系统地量化肌肉减少症对胃癌患者总体生存的预测能力。

方法

根据三个数据库(PubMed/Medline、EMBASE 和 Web of Science),从创建到 2021 年 11 月 30 日进行了系统的文献搜索。本荟萃分析使用固定效应模型汇总了肌肉减少症与非肌肉减少症患者胃癌死亡率风险的风险比及其 95%置信区间。

结果

纳入了 12 项研究,共 5904 名患者。肌肉减少症与胃癌患者的死亡率风险增加相关(风险比:1.46;95%置信区间,1.32-1.61;P < 0.001;I = 23.8%)。亚组分析的结果表明,接受手术的肌肉减少症患者的总体生存率明显缩短。总体而言,本荟萃分析的结果对敏感性和试验序贯分析具有稳健性。

结论

肌肉减少症被确定为胃癌患者总体生存率降低的一个强有力的预测指标。

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