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.

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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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