Tian Long, Wang Yan, Che Guowei
Department of Thoracic Surgery/Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, P.R. China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
Nutr Cancer. 2025;77(6):640-647. doi: 10.1080/01635581.2025.2479878. Epub 2025 Mar 18.
Whether preoperative sarcopenia predicts increased risk of anastomotic leakage in operated esophageal cancer patients remains unclear. This study aimed to identify the relationship between preoperative sarcopenia and the incidence of anastomotic leakage in surgical esophageal cancer.
PubMed, EMBASE, CNKI and Web of Science databases were searched up to October 11, 2024. Odds ratios (ORs) and 95% confidence intervals (CIs) were combined and subgroup analysis based on the pathological type, definition of sarcopenia and history of neoadjuvant therapy were performed.
Fifteen studies with 3,785 patients were included and 368 patients developed the anastomotic leakage (9.72%). Pooled results demonstrated that preoperative sarcopenia was significantly associated with the occurrence of anastomotic leakage among surgical esophageal cancer patients (OR = 1.57, 95% CI: 1.29-1.90, < 0.001). Subgroup analysis by the pathological type and definition of sarcopenia revealed similar results. However, subgroup analysis by the neoadjuvant therapy indicated that preoperative sarcopenia was only related to anastomotic leakage among patients without the history of neoadjuvant therapy (OR = 2.40. 95% CI: 1.61-3.58, < 0.001), and sarcopenia was not a significant risk factor for anastomotic leakage in neoadjuvant therapy treated patients (OR = 1.06, = 0.845).
Preoperative sarcopenia could serve as a risk indicator in surgical esophageal cancer patients without neoadjuvant therapy.
术前肌少症是否会增加食管癌手术患者吻合口漏的风险尚不清楚。本研究旨在确定术前肌少症与食管癌手术中吻合口漏发生率之间的关系。
检索截至2024年10月11日的PubMed、EMBASE、CNKI和Web of Science数据库。合并比值比（OR）和95%置信区间（CI），并根据病理类型、肌少症定义和新辅助治疗史进行亚组分析。
纳入15项研究，共3785例患者，其中368例发生吻合口漏（9.72%）。汇总结果表明，术前肌少症与食管癌手术患者吻合口漏的发生显著相关（OR = 1.57，95%CI：1.29 - 1.90，P < 0.001）。按病理类型和肌少症定义进行的亚组分析显示了相似的结果。然而，按新辅助治疗进行的亚组分析表明，术前肌少症仅与无新辅助治疗史的患者吻合口漏有关（OR = 2.40，95%CI：1.61 - 3.58，P < 0.001），而在接受新辅助治疗的患者中，肌少症不是吻合口漏的显著危险因素（OR = 1.06，P = 0.845）。
术前肌少症可作为未接受新辅助治疗的食管癌手术患者的风险指标。
