虚弱是胃癌患者不良预后的预测因素：对75,357名患者的系统回顾和元分析

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2024-10-02 DOI:10.1016/j.arr.2024.102528

Fei Zhang , Ying Yan , Chunlin Ge

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引用次数: 0

摘要

背景：虚弱是人口老龄化最棘手的表现形式，它与胃癌（GC）患者死亡率和并发症的增加有关。然而，以往关于胃癌患者中体弱人群的虚弱发生率和结局的证据仍然未知：在 Embase、PubMed、Scopus 和 Web of Science 中检索了符合条件的研究，以探讨胃癌患者自发病至 2023 年 11 月 25 日期间的虚弱患病率及其影响。分析了死亡率和术后并发症估算中的合并虚弱患病率、危险比（HR）和相应的95%置信区间（CI）的几率比（OR）：结果：共有 24 项研究涉及 75,357 名胃癌患者。胃癌患者体弱的发生率为 27% (95% CI = 24-30; I2 = 96.7%; p = 0.000)。虚弱与死亡率危险比的增加密切相关（调整后 HR = 2.14；95% CI = 1.60-2.86；I2 = 67.3%，p = 0.000）。此外，体弱与胃癌患者术后并发症的几率增加有明显关系（调整后 OR = 2.65；95% CI = 2.17-3.25；I2 = 0.0%，Cochran's Q = 1.20，p = 0.878）：胃癌患者普遍体弱，这对胃癌患者的预后有显著的不利影响。我们的研究结果凸显了对胃癌患者进行常规虚弱评估的重要性，它可提供预后结果。

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Frailty as a predictor of adverse outcomes in patients with gastric cancer: A systematic review and meta-analysis of 75,357 patients

Background

Frailty is the most problematic expression of population ageing, which has been associated with increased mortality and complications among patients with gastric cancer (GC). However, previous evidence about the frailty prevalence and outcomes in frail populations with gastric cancer remains unknown.

Methods

Eligible studies were searched in Embase, PubMed, Scopus, and Web of Science to explore the prevalence and impact of frailty in patients with gastric cancer from inception until November 25, 2023. The pooled prevalence of frailty, hazard ratio (HR), and odds ratio (OR) corresponding 95 % confidence intervals (CI) in mortality and postoperative complications estimates were analyzed.

Results

A total of 24 studies containing 75,357 GC patients were involved. The prevalence of frailty in gastric cancer was 27 % (95 % CI = 24–30; I² = 96.7 %; p = 0.000). Frailty was independently associated with an increased hazard ratio for mortality (adjusted HR = 2.14; 95 % CI = 1.60–2.86; I² = 67.3 %, p = 0.000). Furthermore, frailty was significantly associated with an increased odds ratio for postoperative complication in GC patients (adjusted OR = 2.65; 95 % CI = 2.17–3.25; I² = 0.0 %, Cochran’s Q = 1.20, p = 0.878).

Conclusion

The prevalence of frailty in gastric cancer is common and has a significant adverse effect on GC patients’ outcomes. Our findings highlight the importance of routine frailty assessment in GC patients, which may provide prognostic outcomes.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.