Aru Na, Yang Congyu, Chen Yuntian, Liu Jiaming
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
BMC Cancer. 2025 Jan 8;25(1):43. doi: 10.1186/s12885-025-13430-7.
Sarcopenia, a condition characterized by the gradual decline of muscle mass, strength, and function, is a key indicator of malnutrition in cancer patients and has been linked to poor prognoses in oncology. Sarcopenia is commonly assessed by measuring the skeletal muscle index (SMI) of the third lumbar spine (L3) using computed tomography (CT). This meta-analysis aimed to explore the relationship between low SMI and clinicopathological features, as well as prognosis, in individuals with endometrial cancer (EC).
Data from various databases including PubMed, Embase, Cochrane, Medline, and Web of Science were searched up until October 20th, 2024. Studies that investigated the association of low SMI and EC survival or clinicopathological characteristics were included. Pooled effect sizes were reported as hazards ratio (HR), odds ratios (ORs) or weighted mean difference (WMD). The quality and risk of bias in the studies were evaluated using the Newcastle-Ottawa Scale (NOS) and the Quality In Prognosis Studies (QUIPS), and the study was registered on PROSPERO (CRD42024509949) before commencing the search.
A total of 218 studies were identified across all five databases, with 11 studies meeting the criteria for qualitative and quantitative analysis, involving 1588 patients. The findings of our meta-analysis demonstrated a significant link between low SMI and progression-free survival [P = 0.002; HR: 1.62, 95% CI: 1.20-2.17]. Low SMI was also associated with a BMI < 25 (P < 0.00001; OR: 4.55, 95% CI: 3.01-6.87), FIGO stage (P = 0.04; OR: 1.33, 95% CI: 1.01-1.75), pathology grades (P = 0.001; OR: 1.77, 95% CI: 1.26-2.49), and the endometrioid pathological type (P = 0.01; OR: 0.68, 95% CI: 0.51-0.92). However, no significant correlation was found between low SMI and 5-year overall survival, serous pathological type, recurrence, length of hospital stay, intraoperative complications, and postoperative complications. All the included studies scored ≥ 7 on the NOS, indicating relatively high-quality evidence.
The meta-analysis highlighted the association between low SMI and unfavorable clinical features and outcomes in EC patients, emphasizing the importance of early diagnosis and appropriate management of sarcopenia assessed by low SMI to enhance prognoses in EC patients.
肌少症是一种以肌肉质量、力量和功能逐渐下降为特征的病症，是癌症患者营养不良的关键指标，且与肿瘤学中的不良预后相关。肌少症通常通过计算机断层扫描（CT）测量第三腰椎（L3）的骨骼肌指数（SMI）来评估。本荟萃分析旨在探讨子宫内膜癌（EC）患者中低SMI与临床病理特征以及预后之间的关系。
检索了包括PubMed、Embase、Cochrane、Medline和Web of Science在内的多个数据库，检索时间截至2024年10月20日。纳入了研究低SMI与EC生存或临床病理特征关联的研究。汇总效应量报告为风险比（HR）、优势比（OR）或加权平均差（WMD）。使用纽卡斯尔-渥太华量表（NOS）和预后研究质量（QUIPS）评估研究的质量和偏倚风险，并且在开始检索之前，该研究已在PROSPERO（CRD42024509949）上注册。
在所有五个数据库中总共识别出218项研究，其中11项研究符合定性和定量分析标准，涉及1588例患者。我们的荟萃分析结果表明，低SMI与无进展生存期之间存在显著关联[P = 0.002；HR：1.62，95%CI：1.20 - 2.17]。低SMI还与BMI < 25（P < 0.00001；OR：4.55，95%CI：3.01 - 6.87）、国际妇产科联盟（FIGO）分期（P = 0.04；OR：1.33，95%CI：1.01 - 1.75）、病理分级（P = 0.001；OR：1.77，95%CI：1.26 - 2.49）以及子宫内膜样病理类型（P = 0.01；OR：0.68，95%CI：0.51 - 0.92）相关。然而，未发现低SMI与5年总生存期、浆液性病理类型、复发、住院时间、术中并发症和术后并发症之间存在显著相关性。所有纳入研究在NOS上的评分均≥7，表明证据质量相对较高。
该荟萃分析强调了低SMI与EC患者不良临床特征和结局之间的关联，强调了早期诊断以及对通过低SMI评估的肌少症进行适当管理以改善EC患者预后的重要性。
