机构:[1]State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, SunYat-sen University Cancer Center, Guangzhou, China[2]Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China[3]Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China四川省人民医院四川省肿瘤医院[4]Department of Radiation Oncology, National Cancer Center/National Clinical Cancer Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China北京大学深圳医院深圳市康宁医院深圳市南山区人民医院深圳医学信息中心中国医学科学院肿瘤医院深圳医院[5]Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
Purpose: Whether or not skeletal muscle mass (SMM) depletion, known as sarcopenia, has significant negative effects on the prognosis of patients with head and neck cancer (HNC) is both new and controversial. In this meta-analysis, we aimed to determine the prognostic significance of sarcopenia in HNC. Methods: We searched PubMed, the Cochrane Library, Embase, and Web of Science, which contain trial registries and meeting proceedings, to identify related published or unpublished studies. We used the Newcastle-Ottawa Scale (NOS) to appraise the risk of bias of the included retrospective studies. Pooled hazard ratios (HR) and the I-2 statistic were estimated for the impact of sarcopenia on overall survival (OS) and relapse-free survival (RFS). Results: We analyzed data from 11 studies involving 2,483 patients (39.4% on average of whom had sarcopenia). Based on the univariate analysis data, the sarcopenia group had significantly poorer OS compared to the non-sarcopenia group [HR = 1.97, 95% confidence interval (CI): 1.71-2.26, I-2 = 0%]. In the cutoff value subgroup, group 1, defined as skeletal muscle index (SMI) of 38.5 cm(2)/m(2) for women and 52.4 cm(2)/m(2) for men (HR = 2.41, 95% CI: 1.72-3.38, I-2 = 0%), had much poorer OS. In the race subgroup, the results were consistent between the Asia (HR = 2.11, 95% CI: 1.59-2.81) and non-Asia group (HR = 1.92, 95% CI: 1.64-2.25). The sarcopenia group also had significantly poorer RFS (HR = 1.74, 95% CI: 1.43-2.12, I-2 = 0%). Conclusions: Presence of pre-treatment sarcopenia has a significant negative impact on OS and RFS in HNC compared with its absence. Further well-conducted studies with detailed stratification are needed to complement our findings.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81772877, 81773103, 81572848]
第一作者机构:[1]State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, SunYat-sen University Cancer Center, Guangzhou, China[2]Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
共同第一作者:
通讯作者:
通讯机构:[1]State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, SunYat-sen University Cancer Center, Guangzhou, China[2]Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China[5]Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
推荐引用方式(GB/T 7714):
Hua Xin,Liu Shan,Liao Jun-Fang,et al.When the Loss Costs Too Much: A Systematic Review and Meta-Analysis of Sarcopenia in Head and Neck Cancer[J].FRONTIERS IN ONCOLOGY.2020,9:doi:10.3389/fonc.2019.01561.
APA:
Hua, Xin,Liu, Shan,Liao, Jun-Fang,Wen, Wen,Long, Zhi-Qing...&Lin, Huan-Xin.(2020).When the Loss Costs Too Much: A Systematic Review and Meta-Analysis of Sarcopenia in Head and Neck Cancer.FRONTIERS IN ONCOLOGY,9,
MLA:
Hua, Xin,et al."When the Loss Costs Too Much: A Systematic Review and Meta-Analysis of Sarcopenia in Head and Neck Cancer".FRONTIERS IN ONCOLOGY 9.(2020)