Lin Luo , Yidan Fan , Yanan Wang , Zhen Wang , Jian Zhou
{"title":"接受术前新辅助治疗的食管癌、胃癌或结直肠癌患者中肌肉疏松症的患病率和临床结果：荟萃分析","authors":"Lin Luo , Yidan Fan , Yanan Wang , Zhen Wang , Jian Zhou","doi":"10.1016/j.apjon.2024.100436","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the prevalence of sarcopenia and its impact on clinical outcomes in patients with esophageal, gastric, or colorectal cancer (EC, GC, and CRC) receiving neoadjuvant therapy through Meta-analysis.</p></div><div><h3>Methods</h3><p>We searched the PubMed, Embase databases, and Cochrane Library for the prevalence of sarcopenia and its impact on clinical outcomes in EC, GC, or CRC patients treated with neoadjuvant therapy (NAT) from inception to November 2022. The primary endpoints were the prevalence of sarcopenia and overall survival in patients with EC, GC, or CRC treated with NAT. Secondary outcomes included recurrence-free survival, total postoperative complications, grade 3–4 chemotherapy toxicity, and 30-day mortality after surgery.</p></div><div><h3>Results</h3><p>Thirty-one retrospective studies with 3651 subjects were included. In a fixed-effects model, the prevalence of muscle loss was higher in patients with EC, GC, or CRC at 50% (95% CI = 42% to 58%). The results of the multivariate analysis showed that preoperative patients with sarcopenia had a 1.91 times shorter overall survival (95% CI = 1.61–2.27) and a 1.77 times shorter recurrence-free survival time (95% CI = 1.33–2.35) than patients without sarcopenia, and that patients with sarcopenia had a higher risk of total postoperative complications than patients without sarcopenia OR = 1.27 (95% CI = 1.03–1.57). However, the two groups had no statistical difference in grade 3–4 chemotherapy toxicity (<em>P</em> = 0.84) or 30-d postoperative mortality (<em>P</em> = 0.88).</p></div><div><h3>Conclusions</h3><p>The prevalence of sarcopenia in patients with EC, GC, or CRC during NAT is high, and it is associated with poorer clinical outcomes. Clinicians should closely monitor the changes in patients’ body composition and guide patients to carry out a reasonable diet and appropriate exercise to improve their poor prognosis and quality of life.</p></div><div><h3>Systematic review registration</h3><p>CRD42023387817.</p></div>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2347562524000568/pdfft?md5=d05f3db6e6c4f57db0607c57bc7110b3&pid=1-s2.0-S2347562524000568-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Prevalence and clinical outcomes of sarcopenia in patients with esophageal, gastric or colorectal cancers receiving preoperative neoadjuvant therapy: A meta-analysis\",\"authors\":\"Lin Luo , Yidan Fan , Yanan Wang , Zhen Wang , Jian Zhou\",\"doi\":\"10.1016/j.apjon.2024.100436\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To investigate the prevalence of sarcopenia and its impact on clinical outcomes in patients with esophageal, gastric, or colorectal cancer (EC, GC, and CRC) receiving neoadjuvant therapy through Meta-analysis.</p></div><div><h3>Methods</h3><p>We searched the PubMed, Embase databases, and Cochrane Library for the prevalence of sarcopenia and its impact on clinical outcomes in EC, GC, or CRC patients treated with neoadjuvant therapy (NAT) from inception to November 2022. The primary endpoints were the prevalence of sarcopenia and overall survival in patients with EC, GC, or CRC treated with NAT. Secondary outcomes included recurrence-free survival, total postoperative complications, grade 3–4 chemotherapy toxicity, and 30-day mortality after surgery.</p></div><div><h3>Results</h3><p>Thirty-one retrospective studies with 3651 subjects were included. In a fixed-effects model, the prevalence of muscle loss was higher in patients with EC, GC, or CRC at 50% (95% CI = 42% to 58%). The results of the multivariate analysis showed that preoperative patients with sarcopenia had a 1.91 times shorter overall survival (95% CI = 1.61–2.27) and a 1.77 times shorter recurrence-free survival time (95% CI = 1.33–2.35) than patients without sarcopenia, and that patients with sarcopenia had a higher risk of total postoperative complications than patients without sarcopenia OR = 1.27 (95% CI = 1.03–1.57). However, the two groups had no statistical difference in grade 3–4 chemotherapy toxicity (<em>P</em> = 0.84) or 30-d postoperative mortality (<em>P</em> = 0.88).</p></div><div><h3>Conclusions</h3><p>The prevalence of sarcopenia in patients with EC, GC, or CRC during NAT is high, and it is associated with poorer clinical outcomes. Clinicians should closely monitor the changes in patients’ body composition and guide patients to carry out a reasonable diet and appropriate exercise to improve their poor prognosis and quality of life.</p></div><div><h3>Systematic review registration</h3><p>CRD42023387817.</p></div>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2347562524000568/pdfft?md5=d05f3db6e6c4f57db0607c57bc7110b3&pid=1-s2.0-S2347562524000568-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2347562524000568\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2347562524000568","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
Prevalence and clinical outcomes of sarcopenia in patients with esophageal, gastric or colorectal cancers receiving preoperative neoadjuvant therapy: A meta-analysis
Objective
To investigate the prevalence of sarcopenia and its impact on clinical outcomes in patients with esophageal, gastric, or colorectal cancer (EC, GC, and CRC) receiving neoadjuvant therapy through Meta-analysis.
Methods
We searched the PubMed, Embase databases, and Cochrane Library for the prevalence of sarcopenia and its impact on clinical outcomes in EC, GC, or CRC patients treated with neoadjuvant therapy (NAT) from inception to November 2022. The primary endpoints were the prevalence of sarcopenia and overall survival in patients with EC, GC, or CRC treated with NAT. Secondary outcomes included recurrence-free survival, total postoperative complications, grade 3–4 chemotherapy toxicity, and 30-day mortality after surgery.
Results
Thirty-one retrospective studies with 3651 subjects were included. In a fixed-effects model, the prevalence of muscle loss was higher in patients with EC, GC, or CRC at 50% (95% CI = 42% to 58%). The results of the multivariate analysis showed that preoperative patients with sarcopenia had a 1.91 times shorter overall survival (95% CI = 1.61–2.27) and a 1.77 times shorter recurrence-free survival time (95% CI = 1.33–2.35) than patients without sarcopenia, and that patients with sarcopenia had a higher risk of total postoperative complications than patients without sarcopenia OR = 1.27 (95% CI = 1.03–1.57). However, the two groups had no statistical difference in grade 3–4 chemotherapy toxicity (P = 0.84) or 30-d postoperative mortality (P = 0.88).
Conclusions
The prevalence of sarcopenia in patients with EC, GC, or CRC during NAT is high, and it is associated with poorer clinical outcomes. Clinicians should closely monitor the changes in patients’ body composition and guide patients to carry out a reasonable diet and appropriate exercise to improve their poor prognosis and quality of life.
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