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探讨肌肉减少症对乳腺癌患者死亡率的影响:一项全面的系统评价和荟萃分析。

Exploring the Impact of Sarcopenia on Mortality in Breast Cancer Patients: A Comprehensive Systematic Review and Meta-Analysis.

作者信息

Dai YanYan, Lan Jiarong, Li Shasha, Xu Guangxing

机构信息

Department of Oncology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, China.

School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Breast Care (Basel). 2024 Dec;19(6):316-328. doi: 10.1159/000541421. Epub 2024 Oct 2.

Abstract

BACKGROUND

This study assesses the frequency of sarcopenia in patients with breast cancer (BC) and its association with mortality rates.

METHODS

An all-encompassing search across (PubMed, Scopus, Web of Science, and CINAHL) was done, to identify studies, published until August 2023, that report data on sarcopenia and mortality in BC patients. A meta-analysis was then done using a random-effects model.

RESULTS

Out of 989 initially identified potential studies, 19 met inclusion criteria. Analysis of 15 studies showed a rate of sarcopenia of 38% (95% CI: 29-48%), with moderate heterogeneity ( = 25.8%). Sarcopenia was linked to increased mortality risk in BC patients across 16 studies (HR: 1.77, CI: 1.35-2.32, = <0.001) with both shorter and longer follow-up periods. Similarly, mortality risks were significantly higher in metastatic (HR: 1.52, CI: 1.14-2.03, = 0.004) and non-metastatic (HR: 2.55, CI: 1.66-3.93, < 0.001) BC patients with sarcopenia.

CONCLUSION

Our analysis demonstrates a substantial prevalence of sarcopenia in BC patients. Importantly, sarcopenia was significantly linked to an elevated risk of mortality in this population. Subgroup analyses, stratified by follow-up periods and disease stage, consistently reveal increased mortality risks associated with sarcopenia, underscoring its clinical relevance in both short- and long-term patient outcomes. Our findings further strengthen the need to recognize and address sarcopenia as a critical factor in BC management and prognosis.

摘要

背景

本研究评估了乳腺癌(BC)患者中肌肉减少症的发生率及其与死亡率的关联。

方法

全面检索了(PubMed、Scopus、Web of Science和CINAHL),以识别截至2023年8月发表的报告BC患者肌肉减少症和死亡率数据的研究。然后使用随机效应模型进行荟萃分析。

结果

在最初确定的989项潜在研究中,19项符合纳入标准。对15项研究的分析显示,肌肉减少症的发生率为38%(95%CI:29-48%),具有中度异质性(I² = 25.8%)。在16项研究中,肌肉减少症与BC患者死亡率风险增加相关(HR:1.77,CI:1.35-2.32,P = <0.001),随访期有长有短。同样,有肌肉减少症的转移性(HR:1.52,CI:1.14-2.03,P = 0.004)和非转移性(HR:2.55,CI:1.66-3.93,P < 0.001)BC患者的死亡风险显著更高。

结论

我们的分析表明BC患者中肌肉减少症的患病率很高。重要的是,肌肉减少症与该人群中死亡率风险升高显著相关。按随访期和疾病阶段分层的亚组分析一致显示,与肌肉减少症相关的死亡风险增加,强调了其在短期和长期患者预后中的临床相关性。我们的研究结果进一步强化了将肌肉减少症作为BC管理和预后的关键因素加以认识和应对的必要性。

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