Prognostic Value of Lumbar Muscle Morphometrics for Survival of Patients with Spinal Metastasis: A Systematic Review and Meta-analysis.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Lu Li, Si Wu, Jin-Chang Han, Xia Kuang, Li-Zhuang Su, Xiao-Qing Zhang, Qing-Tong Cui, Xiao-Yu Zhang
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引用次数: 0

Abstract

Background: Spinal metastasis, a prevalent complication of advanced malignancy, poses significant challenges in patient management due to its potential to compromise spinal stability and quality of life. Accurate prognostication is crucial for tailored therapeutic strategies. This meta-analysis aimed to evaluate the prognostic significance of sarcopenia and lumbar muscle morphometrics in patients with spinal metastasis.

Methods: Electronic databases, including PubMed, Embase, and the CENTRAL, were searched up to August 2024. Studies were included if they reported quantitative data on sarcopenia or lumbar muscle morphometric parameters and survival outcomes in patients with spinal metastasis. A quantitative meta-analysis was performed with hazard ratio (HR) as the effect size. Heterogeneity was assessed using the Cochran Q test and I2 statistic. Publication bias was evaluated through funnel plot symmetry and Egger's and Begg's regression tests.

Results: Our search identified 17 retrospective cohort studies comprising 3,023 patients. Various parameters were employed to assess sarcopenia, encompassing cross-sectional area (CSA) of the psoas muscles (left, right, total, or averaged), the ratio of psoas CSA to vertebral CSA, the ratio of psoas CSA to squared body height, and densities of the psoas or paravertebral muscles. Meta-analysis revealed that total/mean psoas area, when grouped by tertiles or medians, held independent prognostic value for survival outcomes. The ratio of psoas area to vertebral area also demonstrated significant prognostic value when grouped by tertiles or medians.

Conclusions: Lumbar muscle morphometrics are independent prognostic factors for survival in patients with spinal metastasis. Integrating of these metrics into clinical decision-making could enhance personalized therapeutic strategies and prognostic accuracy.

腰肌形态计量学对脊柱转移患者生存的预后价值:系统回顾和荟萃分析。
背景:脊柱转移是晚期恶性肿瘤的一种常见并发症,由于其可能损害脊柱稳定性和生活质量,对患者管理提出了重大挑战。准确的预后对于量身定制的治疗策略至关重要。这项荟萃分析旨在评估肌肉减少症和腰肌形态测量在脊柱转移患者中的预后意义。方法:检索截至2024年8月的PubMed、Embase和CENTRAL等电子数据库。如果研究报告了脊柱转移患者的肌肉减少症或腰肌形态参数和生存结果的定量数据,则纳入研究。以风险比(HR)为效应量进行定量荟萃分析。采用Cochran Q检验和I2统计量评估异质性。通过漏斗图对称和Egger’s和Begg’s回归检验评估发表偏倚。结果:我们的搜索确定了17项回顾性队列研究,包括3,023例患者。采用各种参数来评估肌肉减少症,包括腰肌横截面积(CSA)(左、右、总或平均)、腰肌横截面积与椎体横截面积之比、腰肌横截面积与体高平方之比、腰肌或椎旁肌密度。荟萃分析显示,总/平均腰肌面积,当按位数或中位数分组时,对生存结果具有独立的预后价值。腰大肌面积与椎体面积的比值在按位数或中位数分组时也显示出显著的预后价值。结论:腰肌形态测量是脊柱转移患者生存的独立预后因素。将这些指标整合到临床决策中可以提高个性化的治疗策略和预后的准确性。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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