The prognostic value of myosteatosis in pancreatic cancer: A systematic review and meta-analysis

IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Clinical nutrition Pub Date : 2024-10-16 DOI:10.1016/j.clnu.2024.10.017
Hong-Bo Chen , Qi Miao , Ya-Shu Liu , Xin-Yu Lou , Lu-Dan Zhang , Xiao-Dong Tan , Ke-Ke Liang
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Abstract

Background and aims

The phenomenon of myosteatosis, characterized by the accumulation of ectopic fat within and surrounding skeletal muscle, has been identified as a potential adverse factor in the prognosis of individuals with cancer. This systematic review and meta-analysis sought to examine the association between myosteatosis and survival rates as well as postoperative complications in patients diagnosed with pancreatic cancer (PC).

Methods

A systematic search was conducted on Web of Science, Embase, and Pubmed until March 25, 2024, to identify pertinent articles assessing the prognostic significance of myosteatosis in patients with PC, utilizing the search terms: myosteatosis, PC, and prognosis. The selected studies were utilized to investigate the prognostic impact of myosteatosis on the survival of PC patients. Forest plots and pooled effects models were employed to present the findings of this meta-analysis. The quality of the included studies was evaluated using the Newcastle–Ottawa Scale (NOS). A total of 565 studies were initially identified from the three databases, with 14 retrospective cohort studies ultimately included in the final quantitative analysis.

Results

The meta-analysis revealed a significant association between myosteatosis and both overall survival (OS) [Hazard Ratio (HR): 1.55, 95 % Confidence Interval (CI): 1.40–1.72, P < 0.001, I2 = 0.0 %] and recurrence-free survival (RFS) (HR 1.48, 95 % CI: 1.17–1.86, P = 0.001, I2 = 0.0 %) in patients diagnosed with PC. Subgroup analyses revealed that myosteatosis continued to be a negative prognostic factor in PC across various treatment modalities, patient populations, and myosteatosis assessment methods. Additionally, myosteatosis was identified as a risk factor for postoperative complications, with a pooled odds ratio of 2.20 (95 % CI: 1.45–3.35, P < 0.001, I2 = 37.5 %). All included studies achieved NOS scores of 6 or higher, indicating a relatively high level of methodological quality.

Conclusion

These results suggest that myosteatosis is significantly associated with both survival outcomes and postoperative complications in patients with PC.
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胰腺癌肌骨质疏松症的预后价值:系统回顾和荟萃分析。
背景和目的:肌肉骨质疏松症的特征是骨骼肌内和骨骼肌周围异位脂肪的堆积,已被确定为影响癌症患者预后的潜在不利因素。本系统综述和荟萃分析旨在研究胰腺癌(PC)患者的肌骨肥大症与生存率及术后并发症之间的关系:截至2024年3月25日,我们在Web of Science、Embase和Pubmed上进行了系统检索,以确定评估PC患者肌骨肥大症预后意义的相关文章,检索词包括:肌骨肥大症、PC和预后。所选研究用于调查肌骨营养不良对PC患者生存期的预后影响。荟萃分析采用了森林图和集合效应模型来呈现分析结果。纳入研究的质量采用纽卡斯尔-渥太华量表(NOS)进行评估。从三个数据库中共初步确定了 565 项研究,最终有 14 项回顾性队列研究被纳入最终定量分析:荟萃分析显示,在确诊为 PC 的患者中,肌骨营养不良与总生存期 (OS) [危险比 (HR):1.55,95 % 置信区间 (CI):1.40-1.72,P 2 = 0.0 %]和无复发生存期 (RFS) (HR 1.48,95 % CI:1.17-1.86,P = 0.001,I2 = 0.0 %)之间存在显著关联。亚组分析显示,在不同的治疗方式、患者人群和肌骨骼疏松评估方法中,肌骨骼疏松仍然是PC的一个负面预后因素。此外,肌骨骼疏松还被认为是术后并发症的风险因素,汇总的几率比为 2.20(95 % CI:1.45-3.35,P 2 = 37.5 %)。所有纳入研究的NOS评分均在6分以上,表明研究方法的质量相对较高:这些结果表明,肌骨骼疏松与PC患者的生存结果和术后并发症均有显著相关性。
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来源期刊
Clinical nutrition
Clinical nutrition 医学-营养学
CiteScore
14.10
自引率
6.30%
发文量
356
审稿时长
28 days
期刊介绍: Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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