肥胖对上皮性卵巢癌手术并发症及术后预后的影响：一项荟萃分析。

The effects of obesity on surgical complications and postoperative prognosis of epithelial ovarian cancer: a meta-analysis.

作者信息

Sheng Jingjing, Li Chu, Zhang Jiali, Jin Zujian, Zhou Yun Xiao, Huang Yiping

机构信息

Department of Gynecology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China.

Department of Gynecology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

BMC Surg. 2025 Mar 27;25(1):119. doi: 10.1186/s12893-025-02770-7.

DOI:10.1186/s12893-025-02770-7

PMID:40148940

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11948763/

Abstract

OBJECTIVE

To comprehensively evaluate and compare surgical outcomes of obese patients versus non-obese patients for surgical complications and postoperative prognosis due to epithelial ovarian cancer (EOC).

METHODS

Studies were obtained from database search systems of Medline (PubMed) and Embase. Data were analyzed by the meta-analysis method and the random-effect or fixed-effect model. The heterogeneity between the studies was evaluated by I2 index and the data were analyzed using STATA version 15.1 and Review Manager version 5.4.

RESULTS

14 studies with 4858 cases of proven epithelial ovarian cancer who underwent extensive surgery were included. Obesity may be a risk factor of the low surgical complex score (RR1.08, 95% CI 1.01-1.15, p = 0.05), but had no manifesting difference in the surgical complications score compared non-obesity group (RR 0.50, 95% CI 0.07-3.79, p = 0.501 and RR 0.60, 95% CI 0.22-1.63, p = 0.316). Obesity EOC patients who undergone surgery tended to be correlated with surgical complications, such as wound infection (RR 2.71, 95% CI 1.59-4.61, p = 0.000), intestinal complications (RR 2.09, 95% CI 1.00-4.35, p = 0.000), and 30-readmission rate (RR 1.84, 95% CI 1.16-2.93, p = 0.000). Obese patients were more likely to have shorter prognosis free survival (PFS) (SMD 0.62-year, 95% CI-0.13 to 0.15), but the results did not discover a significant difference in overall survival (OS)between obesity and non-obesity. (SMD 0.01-year, 95% CI-0.13 to 0.15) CONCLUSIONS: Obesity affects the difficulty of ovarian cancer surgery, and a negative relationship between obesity and surgical complications is observed. Obesity is a potential risk factor for prognosis of EOC patients. Attention is played on determining what kind of case should be benefit most from this surgery to minimize the rates of operative complications and postoperative mortality.

PROSPERO REGISTRATION NUMBER

CRD 42,023,434,781.

摘要

目的

全面评估和比较肥胖患者与非肥胖患者因上皮性卵巢癌（EOC）进行手术的并发症及术后预后情况。

方法

从Medline（PubMed）和Embase的数据库检索系统中获取研究。采用荟萃分析方法及随机效应或固定效应模型对数据进行分析。通过I²指数评估研究间的异质性，并使用STATA 15.1版和Review Manager 5.4版对数据进行分析。

结果

纳入了14项研究，共4858例经证实患有上皮性卵巢癌并接受广泛手术的病例。肥胖可能是手术复杂程度评分较低的一个危险因素（风险比率[RR]1.08，95%置信区间[CI]1.01 - 1.15，p = 0.05），但与非肥胖组相比，手术并发症评分无明显差异（RR 0.50，95% CI 0.07 - 3.79，p = 0.501；RR 0.60，95% CI 0.22 - 1.63，p = 0.316）。接受手术的肥胖EOC患者往往与手术并发症相关，如伤口感染（RR 2.71，95% CI 1.59 - 4.61，p = 0.000）、肠道并发症（RR 2.09，95% CI 1.00 - 4.35，p = 0.000）以及30天再入院率（RR 1.84，95% CI 1.16 - 2.93, p = 0.000）。肥胖患者的无进展生存期（PFS）更可能较短（标准化均数差[SMD]为0.62年，95% CI -0.13至0.15），但结果未发现肥胖与非肥胖患者在总生存期（OS）上有显著差异（SMD为0.01年，95% CI -0.13至0.15）。结论：肥胖会影响卵巢癌手术的难度，且观察到肥胖与手术并发症之间存在负相关关系。肥胖是EOC患者预后的一个潜在危险因素。应关注确定哪种病例能从该手术中获益最大，以尽量降低手术并发症发生率和术后死亡率。