Prevalence of and Survival with Cachexia among Patients with Cancer: A Systematic Review and Meta-Analysis

IF 8 1区 医学 Q1 NUTRITION & DIETETICS Advances in Nutrition Pub Date : 2024-09-01 DOI:10.1016/j.advnut.2024.100282
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Abstract

Cachexia is associated with lower overall survival (OS) in patients with cancer; however, the relationship between the two is reported to differ according to the definitive criteria for diagnosing cachexia.

We aimed to investigate 1) the difference in the prevalence of cachexia in patients with cancer and 2) the association between cachexia and OS, depending on the definitive criteria for diagnosing cachexia in patients with cancer. We searched PubMed and Web of Science from their inception until July 31, 2023, to identify eligible studies. We conducted a systematic review of the prevalence of cachexia in patients with cancer and performed a meta-analysis to investigate its relationship with OS. A total of 125 articles comprising 137,960 patients were included in the systematic review, and 26 articles consisting of 11,118 patients underwent meta-analysis. The overall prevalence of cachexia in patients with cancer was 33.0% (95% confidence interval [CI]: 32.8, 33.3); however, it varied according to the definitive criteria for diagnosing cachexia (13.9%–56.5%). According to the Fearon 2011 criteria, the prevalence of cachexia was associated with a high hazard ratio (HR) for OS compared with that of noncachexia [HR: 1.58 (95% CI: 1.45, 1.73)]; according to the other criteria, the HR was 2.78 (95% CI: 1.88, 4.11), indicating significant subgroup differences (P = 0.006). The dose–response curve indicated that the HR for OS plateaued at a cachexia prevalence range of 40%–50% (l-shaped relationship). The prevalence of cachexia in patients with cancer may vary depending on the definitive criteria used to diagnose cachexia. The HR for OS was higher for low cachexia prevalence. The definitive criteria should be carefully considered when assessing cachexia in patients with cancer.

This trial was registered at the PROSPERO as CRD42023435474.

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癌症患者恶病质的发生率和存活率:系统回顾和荟萃分析。
背景:恶病质与癌症患者较低的总生存率有关;然而,据报道,两者之间的关系因诊断恶病质的明确标准而异:我们的目的是调查:(1) 癌症患者恶病质发生率的差异;(2) 癌症患者恶病质与总生存率之间的关系,这取决于诊断癌症患者恶病质的明确标准:我们检索了从 PubMed 和 Web of Science 开始到 2023 年 7 月 31 日的资料,以确定符合条件的研究。我们对癌症患者恶病质的发生率进行了系统回顾,并进行了荟萃分析,以研究恶病质与总生存期的关系:共有125篇文章(137960名患者)被纳入系统综述,26篇文章(11118名患者)进行了荟萃分析。癌症患者恶病质的总发生率为 33.0%(95% 置信区间 [CI],32.8-33.3);但根据诊断恶病质的明确标准不同,发生率也不同(13.9-56.5%)。根据 Fearon 2011 标准,与非恶病质相比,恶病质的发生率与总生存率的高危险比(HR)相关(HR:1.58 [95% CI,1.45-1.73]);根据其他标准,HR 为 2.78(95% CI,1.88-4.11),显示出显著的亚组差异(P = 0.006)。剂量反应曲线显示,当恶病质发生率在40%-50%之间时,总生存率趋于稳定(L型关系):结论:癌症患者的恶病质发生率可能因诊断恶病质的明确标准而异。恶病质发生率低的患者总生存率更高。在评估癌症患者的恶病质时,应仔细考虑明确的标准。本研究已在 PROSPERO 注册,注册号为 CRD42023435474:本研究为临床实践中癌症恶病质鉴别诊断标准对预后的影响提供了重要见解。我们提供的定量和定性证据表明,根据癌症患者恶病质的明确诊断标准,患者的总生存率和恶病质发生率存在显著差异。
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来源期刊
Advances in Nutrition
Advances in Nutrition 医学-营养学
CiteScore
17.40
自引率
2.20%
发文量
117
审稿时长
56 days
期刊介绍: Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.
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