Pretreatment Skeletal Muscle Index and Survival Outcomes in Non-Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-06-27 DOI:10.1007/s12029-025-01267-z

Clifford Atuiri, Isaac Che Ngang, Daniel Appiah, Armel Landry Batchi-Bouyou, Kayode Ademola Matthew, Abel Zemedkun Girma, Lawrence Sentongo Katumba, Leslie Tasha Mbapah, Semere Bekena

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引用次数: 0

Abstract

Background: Skeletal muscle index (SMI), a measure of muscle mass derived from pretreatment imaging, has emerged as a potential prognostic factor in cancer. Its role in non-metastatic colorectal cancer (CRC), where curative treatment is possible, remains underexplored.

Purpose: To evaluate the association between pretreatment SMI and survival outcomes, specifically overall survival (OS) and disease-free survival (DFS), in patients with non-metastatic CRC through a systematic review and meta-analysis.

Methods: We searched PubMed, Embase, SCOPUS, Web of Science, Cochrane Library, and ClinicalTrials.gov from inception to March 24, 2025, for studies reporting SMI (measured via CT scan at L3) and survival outcomes in non-metastatic CRC. Studies were assessed for quality using the Newcastle-Ottawa Scale (NOS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was evaluated with the I² statistic.

Results: Seventeen studies, comprising 16,031 patients, were included. Low SMI was associated with a 28% higher risk of overall mortality (pooled HR for OS: 1.28, 95% CI: 1.04-1.57, p = 0.02) and a 23% higher risk of recurrence/progression (pooled HR for DFS: 1.23, 95% CI: 1.02-1.49, p = 0.02). Heterogeneity was high reflecting variability in SMI cutoffs and study designs.

Conclusion: Low pretreatment SMI is a significant predictor of poorer OS and DFS in non-metastatic CRC. Its routine assessment via existing CT scans could enhance risk stratification and guide interventions to improve outcomes. High study heterogeneity warrants further research to standardize measurement thresholds and clarify its clinical utility.

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预处理骨骼肌指数和非转移性结直肠癌的生存结果：系统回顾和荟萃分析。

背景：骨骼肌指数（SMI）是一种由预处理成像得出的肌肉质量测量指标，已成为癌症的潜在预后因素。它在可治愈的非转移性结直肠癌（CRC）中的作用仍未得到充分探讨。目的：通过系统回顾和荟萃分析，评估预处理SMI与非转移性结直肠癌患者生存结局，特别是总生存期（OS）和无病生存期（DFS）之间的关系。方法：我们检索了PubMed， Embase， SCOPUS, Web of Science， Cochrane Library和ClinicalTrials.gov，从成立到2025年3月24日，报告了非转移性CRC的SMI（通过L3级CT扫描测量）和生存结果的研究。使用纽卡斯尔-渥太华量表（NOS）评估研究的质量。风险比（hr）和95%置信区间（ci）采用随机效应模型进行汇总。采用I2统计量评价异质性。结果：纳入17项研究，共16031例患者。低SMI与总死亡风险增加28%相关（OS的合并HR: 1.28, 95% CI: 1.04-1.57, p = 0.02），复发/进展风险增加23%相关（DFS的合并HR: 1.23, 95% CI: 1.02-1.49, p = 0.02）。异质性高度反映了SMI截止点和研究设计的可变性。结论：低预处理SMI是非转移性结直肠癌较差OS和DFS的重要预测因子。通过现有的CT扫描进行常规评估可以增强风险分层并指导干预措施改善结果。研究异质性高，需要进一步研究以规范测量阈值并明确其临床应用。

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

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.