Zhang Fei, Yan Ying, Li Baifeng, Ge Chunlin
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of China Medical University, Shenyang, 110001, China.
Department of Urinary Surgery, Northeast International Hospital, Shenyang, 110623, China.
HPB (Oxford). 2025 Mar;27(3):279-288. doi: 10.1016/j.hpb.2024.12.009. Epub 2024 Dec 12.
Frailty has been associated with increased mortality and complications among liver cancer patients. However, the frailty prevalence and outcomes in frail populations with primary liver cancer have not been systematically validated.
Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in liver cancers from inception until October 26, 2023. The pooled prevalence, hazard ratio (HR), and odds ratio (OR) corresponding to 95 % confidence intervals (CI) in mortality and major complication estimates were conducted.
A total of 18 studies containing 38,157 primary liver cancer patients were included. The prevalence of frailty in liver cancer was 35 % (95 % CI = 25-46; p = 0.000). Frailty was associated with an increased hazard ratio for 30-day mortality (HR = 7.03; 95 % CI = 0.71-69.45; p = 0.97) and 90-day mortality (HR = 4.59; 95 % CI = 1.76-11.95; p = 0.38). Furthermore, frailty was associated with an increased odds ratio for major complications in liver cancer patients (OR = 4.01; 95 % CI = 2.25-7.14; p = 0.49).
Frailty is frequent in liver cancer patients and may predict adverse outcomes in primary liver cancer patients with hepatectomy. Our findings highlight the importance of frailty assessment in this population.
衰弱与肝癌患者死亡率和并发症增加相关。然而，原发性肝癌虚弱人群中的衰弱患病率及预后尚未得到系统验证。
检索Embase、PubMed、Scopus和Web of Science数据库，查找自数据库建立至2023年10月26日期间探讨衰弱在肝癌中的患病率及影响的合格研究。计算合并患病率、风险比（HR）以及对应95%置信区间（CI）的优势比（OR），以评估死亡率和主要并发症。
共纳入18项研究，包含38157例原发性肝癌患者。肝癌患者中衰弱的患病率为35%（95%CI = 25 - 46；p = 0.000）。衰弱与30天死亡率的风险比增加相关（HR = 7.03；95%CI = 0.71 - 69.45；p = 0.97）以及90天死亡率（HR = 4.59；95%CI = 1.76 - 11.95；p = 0.38）。此外，衰弱与肝癌患者主要并发症的优势比增加相关（OR = 4.01；95%CI = 2.25 - 7.14；p = 0.49）。
衰弱在肝癌患者中很常见，可能预测接受肝切除术的原发性肝癌患者的不良结局。我们的研究结果凸显了对该人群进行衰弱评估的重要性。
