Bingyan Zhao, Min Wu, Leilei Bao, Si-Ai Zhang, Chunmei Zhang
{"title":"食管癌术前虚弱：术后结局和总生存率-荟萃分析和系统评价。","authors":"Bingyan Zhao, Min Wu, Leilei Bao, Si-Ai Zhang, Chunmei Zhang","doi":"10.1136/spcare-2024-005073","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To assess the prevalence of preoperative frailty in patients with oesophageal cancer and its impact on postoperative outcomes and overall survival.</p><p><strong>Methods: </strong>A comprehensive computer-based search of the CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases was conducted for articles related to preoperative frailty in patients with oesophageal cancer. The search was carried out from the time of the construction of the database to 20 April 2024. Data related to the prevalence of preoperative frailty in patients with oesophageal cancer and their postoperative outcomes and overall survival were extracted.</p><p><strong>Results: </strong>A total of 13 studies were included, including 12 cohort studies and 1 cross-sectional study involving 53 485 patients. Meta-analysis showed that the prevalence of preoperative frailty in patients with oesophageal cancer was 29.6% (95% CI 24.5% to 34.8%). Preoperative frailty increased the risk of postoperative mortality (HR 1.80, 95% CI 1.51 to 2.14, p<0.001), complications (HR 1.32, 95% CI 1.16 to 1.49, p<0.001) and 30-day readmission (HR 1.24, 95% CI 1.18 to 1.31, p<0.001), in patients with oesophageal cancer, but had no significant effect on overall survival (HR 1.28, 95% CI 0.97 to 1.68, p=0.08).</p><p><strong>Conclusions: </strong>The prevalence of preoperative frailty is high in patients with oesophageal cancer, and preoperative frailty is strongly associated with increased adverse outcomes after surgery. Healthcare providers should identify preoperative frailty in patients with oesophageal cancer at an early stage and develop targeted intervention strategies to reduce the incidence of postoperative adverse outcomes.</p><p><strong>Prospero registration number: </strong>CRD42024541051.</p>","PeriodicalId":9136,"journal":{"name":"BMJ Supportive & Palliative Care","volume":" ","pages":"149-157"},"PeriodicalIF":2.0000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Preoperative frailty in oesophageal cancer: postoperative outcomes and overall survival - meta-analysis and systematic review.\",\"authors\":\"Bingyan Zhao, Min Wu, Leilei Bao, Si-Ai Zhang, Chunmei Zhang\",\"doi\":\"10.1136/spcare-2024-005073\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To assess the prevalence of preoperative frailty in patients with oesophageal cancer and its impact on postoperative outcomes and overall survival.</p><p><strong>Methods: </strong>A comprehensive computer-based search of the CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases was conducted for articles related to preoperative frailty in patients with oesophageal cancer. The search was carried out from the time of the construction of the database to 20 April 2024. Data related to the prevalence of preoperative frailty in patients with oesophageal cancer and their postoperative outcomes and overall survival were extracted.</p><p><strong>Results: </strong>A total of 13 studies were included, including 12 cohort studies and 1 cross-sectional study involving 53 485 patients. Meta-analysis showed that the prevalence of preoperative frailty in patients with oesophageal cancer was 29.6% (95% CI 24.5% to 34.8%). Preoperative frailty increased the risk of postoperative mortality (HR 1.80, 95% CI 1.51 to 2.14, p<0.001), complications (HR 1.32, 95% CI 1.16 to 1.49, p<0.001) and 30-day readmission (HR 1.24, 95% CI 1.18 to 1.31, p<0.001), in patients with oesophageal cancer, but had no significant effect on overall survival (HR 1.28, 95% CI 0.97 to 1.68, p=0.08).</p><p><strong>Conclusions: </strong>The prevalence of preoperative frailty is high in patients with oesophageal cancer, and preoperative frailty is strongly associated with increased adverse outcomes after surgery. Healthcare providers should identify preoperative frailty in patients with oesophageal cancer at an early stage and develop targeted intervention strategies to reduce the incidence of postoperative adverse outcomes.</p><p><strong>Prospero registration number: </strong>CRD42024541051.</p>\",\"PeriodicalId\":9136,\"journal\":{\"name\":\"BMJ Supportive & Palliative Care\",\"volume\":\" \",\"pages\":\"149-157\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Supportive & Palliative Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/spcare-2024-005073\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Supportive & Palliative Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/spcare-2024-005073","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
目的：评估食管癌患者术前虚弱的发生率及其对术后预后和总生存期的影响。方法：计算机检索CNKI、万方、VIP、CBM、PubMed、Embase、Cochrane Library、Web of Science、CINAHL等数据库，检索与食管癌患者术前虚弱相关的文章。检索时间从数据库建立之日起至2024年4月20日止。我们提取了食管癌患者术前虚弱的患病率、术后结局和总生存期的相关数据。结果：共纳入13项研究，包括12项队列研究和1项横断面研究，共纳入53 485例患者。meta分析显示食管癌患者术前虚弱的患病率为29.6% （95% CI 24.5% ~ 34.8%）。术前虚弱增加了术后死亡风险（HR 1.80, 95% CI 1.51 - 2.14）。结论：食管癌患者术前虚弱的患病率较高，术前虚弱与术后不良结局的增加密切相关。医疗保健提供者应在早期阶段识别食管癌患者的术前虚弱，并制定有针对性的干预策略，以减少术后不良后果的发生率。普洛斯彼罗注册号：CRD42024541051。
Preoperative frailty in oesophageal cancer: postoperative outcomes and overall survival - meta-analysis and systematic review.
Purpose: To assess the prevalence of preoperative frailty in patients with oesophageal cancer and its impact on postoperative outcomes and overall survival.
Methods: A comprehensive computer-based search of the CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases was conducted for articles related to preoperative frailty in patients with oesophageal cancer. The search was carried out from the time of the construction of the database to 20 April 2024. Data related to the prevalence of preoperative frailty in patients with oesophageal cancer and their postoperative outcomes and overall survival were extracted.
Results: A total of 13 studies were included, including 12 cohort studies and 1 cross-sectional study involving 53 485 patients. Meta-analysis showed that the prevalence of preoperative frailty in patients with oesophageal cancer was 29.6% (95% CI 24.5% to 34.8%). Preoperative frailty increased the risk of postoperative mortality (HR 1.80, 95% CI 1.51 to 2.14, p<0.001), complications (HR 1.32, 95% CI 1.16 to 1.49, p<0.001) and 30-day readmission (HR 1.24, 95% CI 1.18 to 1.31, p<0.001), in patients with oesophageal cancer, but had no significant effect on overall survival (HR 1.28, 95% CI 0.97 to 1.68, p=0.08).
Conclusions: The prevalence of preoperative frailty is high in patients with oesophageal cancer, and preoperative frailty is strongly associated with increased adverse outcomes after surgery. Healthcare providers should identify preoperative frailty in patients with oesophageal cancer at an early stage and develop targeted intervention strategies to reduce the incidence of postoperative adverse outcomes.
期刊介绍：
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
