Wang Xiaofeng, Wu Min, Liu Qian, He Wei, Tian Yong, Zhang Yan, Li Cuiping, Liu Yanni, Yu Anqi, Jin Hongyan
Department of Oncology, Wuhan Puren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China.
Department of Oncology, Third People's Hospital of Honghe Prefecture, Gejiu, China.
Front Oncol. 2024 Jul 19;14:1403822. doi: 10.3389/fonc.2024.1403822. eCollection 2024.
The purpose of this study is to investigate potential associations between osteopenia, osteosarcopenia, and postoperative outcomes in patients with hepatobiliary-pancreatic cancer (HBPC).
Three online databases, including Embase, PubMed, and the Cochrane Library, were thoroughly searched for literature describing the relationship between osteopenia, osteosarcopenia, and outcomes of surgical treatment of HBPC patients from the start of each database to September 29, 2023. The Newcastle-Ottawa Scale was used to rate the quality of the studies.
This analysis included a total of 16 articles with a combined patient cohort of 2,599 individuals. The results demonstrated that HBPC patients with osteopenia had significantly inferior OS (HR: 2.27, 95% CI: 1.70-3.03, < 0.001) and RFS (HR: 1.96, 95% CI: 1.42-2.71, < 0.001) compared to those without osteopenia. Subgroup analysis demonstrated that these findings were consistent across univariate and multivariate analyses, as well as hepatocellular carcinoma, biliary tract cancer, and pancreatic cancer. The risk of postoperative major complications was significantly higher in patients with osteopenia compared to those without osteopenia (OR: 1.66, 95% CI: 1.19-2.33, < 0.001). Besides, we also found that the presence of osteosarcopenia in HBPC patients was significantly related to poorer OS (HR: 3.31, 95% CI: 2.00-5.48, < 0.001) and PFS (HR: 2.50, 95% CI: 1.62-3.84, < 0.001) in comparison to those without osteosarcopenia.
Preoperative osteopenia and osteosarcopenia can predict poorer OS and RFS with HBPC after surgery.
本研究旨在调查骨质疏松症、肌少骨质疏松症与肝胆胰癌（HBPC）患者术后结局之间的潜在关联。
全面检索了三个在线数据库，包括Embase、PubMed和Cochrane图书馆，以查找从每个数据库建立之初至2023年9月29日描述骨质疏松症、肌少骨质疏松症与HBPC患者手术治疗结局之间关系的文献。使用纽卡斯尔-渥太华量表对研究质量进行评分。
本分析共纳入16篇文章，合并患者队列共2599人。结果表明，与无骨质疏松症的HBPC患者相比，患有骨质疏松症的患者总生存期（HR：2.27，95%CI：1.70-3.03，P<0.001）和无复发生存期（HR：1.96，95%CI：1.42-2.71，P<0.001）明显较差。亚组分析表明，这些结果在单变量和多变量分析以及肝细胞癌、胆管癌和胰腺癌中均一致。与无骨质疏松症的患者相比，患有骨质疏松症的患者术后发生主要并发症的风险明显更高（OR：1.66，95%CI：1.19-2.33，P<0.001）。此外，我们还发现，与无肌少骨质疏松症的HBPC患者相比，患有肌少骨质疏松症的患者总生存期（HR：3.31，95%CI：2.00-5.48，P<0.001）和无进展生存期（HR：2.50，95%CI：1.62-3.84，P<0.001）明显较差。
术前骨质疏松症和肌少骨质疏松症可预测HBPC术后较差的总生存期和无复发生存期。
