Preoperative low skeletal muscle mass index assessed using L3-CT as a prognostic marker of clinical outcomes in pancreatic cancer patients undergoing surgery: a systematic review and meta-analysis.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2024-10-01 DOI:10.1097/JS9.0000000000000989

Pauline Raoul, Marco Cintoni, Alessandro Coppola, Sergio Alfieri, Giampaolo Tortora, Antonio Gasbarrini, Maria Cristina Mele, Emanuele Rinninella

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引用次数: 0

Abstract

Background: Reduction in muscle mass can be routinely quantified using computed tomography (CT) of the third lumbar vertebra (L3) during a curative pancreatic cancer (PC) course. This systematic review and meta-analysis aimed to assess the association between preoperative low skeletal muscle index (SMI) measured by L3-CT and postoperative clinical outcomes in PC resectable patients.

Methods: Three electronic databases (PubMed, Web of Science, and Scopus) were searched for articles published through May 2023. Duplicate titles and abstracts, full-text screening, and data extraction were performed. A meta-analysis was performed for overall survival (OS), recurrence-free survival (RFS), postoperative pancreatic fistula (POPF), morbidity, and postoperative length of stay (P-LOS). The risk of bias was assessed.

Results: A total of 2942 patients with PC from 11 studies were identified. Preoperative low SMI was found in 50.9% of PC resectable patients. Preoperative low SMI was significantly associated with adjusted OS (adjusted hazard ratio, 1.52; 95% CI 1.25-1.86, P < 0.0001). No significant associations were found between preoperative low SMI and RFS, number of POPF, significant morbidity, and P-LOS ( P >0.05).

Conclusions: SMI should be evaluated in a timely manner as a predictor of OS in PC resectable patients. Studies assessing nutritional protocols for maintaining/increasing skeletal muscle mass are required to develop a personalized nutritional approach to improve clinical outcomes.

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使用 L3-CT 评估术前低骨骼肌质量指数，作为接受手术的胰腺癌患者临床预后的指标：系统综述和荟萃分析。

背景：在胰腺癌（PC）治愈过程中，可通过第三腰椎（L3）计算机断层扫描（CT）对肌肉质量的减少进行常规量化。本系统综述和荟萃分析旨在评估L3 CT测量的术前低骨骼肌指数（SMI）与可切除胰腺癌患者术后临床预后之间的关系：检索了三个电子数据库（PubMed、Web of Science 和 Scopus）中截至 2023 年 5 月发表的文章。对重复的标题和摘要、全文进行筛选并提取数据。对总生存期（OS）、无复发生存期（RFS）、术后胰瘘（POPF）、发病率和术后住院时间（P-LOS）进行了荟萃分析。对偏倚风险进行了评估：结果：共确定了 11 项研究中的 2942 例 PC 患者。在 50.9% 的可切除 PC 患者中发现了术前低 SMI。术前低 SMI 与调整后 OS 显著相关（调整后 HR，1.52；95% CI 1.25-1.86，P< 0.0001）。术前低SMI与RFS、POPF数量、重大发病率和P-LOS之间无明显相关性（P>0.05）：结论：应及时评估 SMI，以预测 PC 可切除患者的 OS。需要对维持/增加骨骼肌质量的营养方案进行评估研究，以制定个性化的营养方法，改善临床预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.