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体重减轻作为肺癌患者生存预后不良的预测因素:一项系统评价与Meta分析

Weight loss as a predictor of reduced survival in patients with lung cancer: a systematic review with meta-analysis.

作者信息

Zhang Junfang, Tang Xuan, Zhang Wenbo, Xu Ying, Zhang Heng, Fan Yu

机构信息

Department of Medical Nutrition, Nanjing Lishui District People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, 211200, China.

Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, 212002, China.

出版信息

Int J Obes (Lond). 2025 Jan;49(1):13-20. doi: 10.1038/s41366-024-01642-z. Epub 2024 Oct 3.

Abstract

BACKGROUND

The impact of weight loss on survival outcomes remains challenging in patients with lung cancer. The objective of this systematic review with meta-analysis was to assess the association of weight loss with survival outcomes in these patients.

METHODS

Two authors conducted a comprehensive literature search of PubMed, Web of Science, and Embase databases up to January 15, 2024. Observational studies that assessed the weight loss as a prognostic factor of overall survival and progression-free survival in patients with lung cancer were included this analysis. Weight loss defined by at least 5% loss of total body weight over 2 months.

RESULTS

Fifteen studies involving 14,540 patients with lung cancer were included. Pooled adjusted hazard ratios (HR) indicated that weight loss was associated with reduced overall survival (HR 1.65; 95% confidence intervals [CI] 1.43-1.91) and progression-free survival (HR 1.40; 95% CI 1.15-1.71). Subgroup analysis showed that weight loss significantly predicted overall survival, regardless of study design, lung cancer subtypes, clinical stage of cancer, weight loss definition, or length of follow-up.

CONCLUSIONS

Weight loss is a significant predictor of overall survival and progression-free survival in patients with lung cancer. Weight monitoring has potential to improve prognostication of survival outcomes for these patients.

摘要

背景

体重减轻对肺癌患者生存结局的影响仍具有挑战性。本系统评价及荟萃分析的目的是评估体重减轻与这些患者生存结局之间的关联。

方法

两位作者对截至2024年1月15日的PubMed、Web of Science和Embase数据库进行了全面的文献检索。本分析纳入了评估体重减轻作为肺癌患者总生存和无进展生存预后因素的观察性研究。体重减轻定义为2个月内总体重至少减轻5%。

结果

纳入了15项涉及14540例肺癌患者的研究。合并调整后的风险比(HR)表明,体重减轻与总生存降低(HR 1.65;95%置信区间[CI] 1.43 - 1.91)和无进展生存降低(HR 1.40;95% CI 1.15 - 1.71)相关。亚组分析表明,无论研究设计、肺癌亚型、癌症临床分期、体重减轻定义或随访时间长短,体重减轻均显著预测总生存。

结论

体重减轻是肺癌患者总生存和无进展生存的重要预测因素。体重监测有可能改善这些患者生存结局的预后评估。

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