Liang Hongliang, Hu Aiping
Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng, China.
Department of Oncology, Liaocheng Tumor Hospital, Liaocheng, China.
Front Oncol. 2023 Sep 21;13:1239781. doi: 10.3389/fonc.2023.1239781. eCollection 2023.
The relationship between frailty and the long-term clinical outcome of gastric cancer (GC) patients has not yet been established, although frailty is associated with a poor short-term outcome. The impact of frailty on long-term survival of GC patients was investigated through a systematic review and meta-analysis.
Observational studies with longitudinal follow-ups for a minimum of one year were identified through a search of the PubMed, Embase, Cochrane Library, and Web of Science databases, in accordance with the objective of the meta-analysis. Combining the findings was achieved using a random-effects model, which accounted for inter-study heterogeneity.
Ten datasets from nine cohort studies were included, which involved 7613 patients with GC. A total of 2074 patients (27.2%) were with frailty at baseline, and the mean follow-up duration was 48.1 months. A pooled analysis of the results showed that frailty was linked to a poor long-term overall survival in GC patients (risk ratio [RR]: 1.65, 95% confidence interval [CI]: 1.27 to 2.13, p < 0.001; I = 80%). Sensitivity analysis showed consistent results in older patients (≥ 65 years, RR: 1.51, p = 0.002) and the oldest old (≥ 80 years, RR: 1.41, p = 0.01). In addition, frailty was also associated with poor long-term progression-free survival (RR: 1.65, 95% CI: 1.39 to 1.96, p < 0.001; I = 0%) and disease-specific survival (RR: 1.71, 95% CI: 1.23 to 2.37, p = 0.001; I = 4%).
Frailty is associated with poor long-term survival of patients with GC.
尽管虚弱与胃癌（GC）患者的短期预后不良相关，但虚弱与GC患者长期临床结局之间的关系尚未明确。通过系统评价和荟萃分析，研究了虚弱对GC患者长期生存的影响。
根据荟萃分析的目的，通过检索PubMed、Embase、Cochrane图书馆和Web of Science数据库，确定了至少进行一年纵向随访的观察性研究。采用随机效应模型合并研究结果，该模型考虑了研究间的异质性。
纳入了9项队列研究中的10个数据集，涉及7613例GC患者。共有2074例患者（27.2%）在基线时存在虚弱，平均随访时间为48.1个月。结果的汇总分析表明，虚弱与GC患者较差的长期总生存率相关（风险比[RR]：1.65，95%置信区间[CI]：1.27至2.13，p<0.001；I² = 80%）。敏感性分析显示，老年患者（≥65岁，RR：1.51，p = 0.002）和高龄老人（≥80岁，RR：1.41，p = 0.01）的结果一致。此外，虚弱还与较差的长期无进展生存率（RR：1.65，95%CI：1.39至1.96，p<0.001；I² = 0%）和疾病特异性生存率（RR：1.71，95%CI：1.23至2.37，p = 0.001；I² = 4%）相关。
虚弱与GC患者的长期生存不良相关。
