Significance of frailty in mortality and complication after hepatectomy for patients with liver cancer: a systematic review and meta-analysis

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-03-01 DOI:10.1016/j.hpb.2024.12.009

Fei Zhang , Ying Yan , Baifeng Li , Chunlin Ge

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引用次数: 0

Abstract

Background

Frailty has been associated with increased mortality and complications among liver cancer patients. However, the frailty prevalence and outcomes in frail populations with primary liver cancer have not been systematically validated.

Methods

Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in liver cancers from inception until October 26, 2023. The pooled prevalence, hazard ratio (HR), and odds ratio (OR) corresponding to 95 % confidence intervals (CI) in mortality and major complication estimates were conducted.

Results

A total of 18 studies containing 38,157 primary liver cancer patients were included. The prevalence of frailty in liver cancer was 35 % (95 % CI = 25–46; p = 0.000). Frailty was associated with an increased hazard ratio for 30-day mortality (HR = 7.03; 95 % CI = 0.71–69.45; p = 0.97) and 90-day mortality (HR = 4.59; 95 % CI = 1.76–11.95; p = 0.38). Furthermore, frailty was associated with an increased odds ratio for major complications in liver cancer patients (OR = 4.01; 95 % CI = 2.25–7.14; p = 0.49).

Conclusion

Frailty is frequent in liver cancer patients and may predict adverse outcomes in primary liver cancer patients with hepatectomy. Our findings highlight the importance of frailty assessment in this population.

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虚弱在肝癌患者肝切除术后死亡率和并发症中的意义：一项系统回顾和荟萃分析。

背景：虚弱与肝癌患者死亡率和并发症的增加有关。然而，原发性肝癌虚弱人群的虚弱患病率和预后尚未得到系统验证。方法：检索Embase、PubMed、Scopus和Web of Science，从研究开始到2023年10月26日，这些研究探讨了虚弱在肝癌中的患病率和影响。在死亡率和主要并发症的估计中，汇总患病率、危险比（HR）和比值比（OR）对应95%置信区间（CI）。结果：共纳入18项研究，共38157例原发性肝癌患者。衰弱在肝癌中的患病率为35% (95% CI = 25-46；p = 0.000)。虚弱与30天死亡率的风险比增加相关(HR = 7.03；95% ci = 0.71-69.45；p = 0.97)和90天死亡率(HR = 4.59；95% ci = 1.76-11.95；p = 0.38)。此外，虚弱与肝癌患者主要并发症的优势比增加相关(OR = 4.01；95% ci = 2.25-7.14；p = 0.49)。结论：虚弱是肝癌患者的常见病，可能预示原发性肝癌肝切除术患者的不良预后。我们的研究结果强调了在这一人群中进行脆弱性评估的重要性。

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

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).