Liqian Xu1,2, Yuxia Jing3, Chen Zhao4, Qin Zhang1,2, Xiaohong Zhao1,2, Ji Yang1,2, Lizhen Wu1,2, Yunmei Yang1,2. 1. Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 2. Department of Geriatrics, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 3. Department of Geriatrics, Tianjin Fifth Central Hospital, Tianjin, China. 4. Institute of Physical Education, Huzhou University, Huzhou, China.
Abstract
BACKGROUND: Recently, several studies have examined the association between preoperative sarcopenia and prognosis evaluation in patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. However, their conclusions remain ambiguous and controversial. Thus, we conducted a meta-analysis to assess the prognostic role of preoperative sarcopenia in patients with HCC undergoing hepatectomy. METHODS: We searched the existing literature reporting on the prognostic value of preoperative computed tomography (CT)-assessed sarcopenia for the survival of patients with HCC undergoing hepatectomy. The pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of overall survival (OS) and disease-free survival (DFS) were used to assess the prognostic value of preoperative sarcopenia in HCC patients. The associations between preoperative sarcopenia and clinicopathological characteristics were also evaluated. RESULTS: A total of six studies with 1,420 patients (including 458 sarcopenia and 962 non-sarcopenia patients) were included in the meta-analysis. The results showed that preoperative sarcopenia was significantly associated with poor OS (HR =1.572, 95% CI: 1.342-1.840, P=0) and shorter DFS (HR =1.544, 95% CI: 1.178-2.024, P=0.002) in patients with HCC undergoing hepatectomy. Preoperative sarcopenia was also significantly related to larger diameter tumors (WMD =0.598, 95% CI: 0.216-0.980, P=0.002). The results of the sensitivity analysis were stable in this meta-analysis. Egger's tests revealed that there was no significant publication bias. CONCLUSIONS: Sarcopenia appears to have significant adverse impacts on postoperative outcomes in patients with hepatocellular carcinoma following hepatectomy. However, further large-scale prospective studies are needed to confirm our findings. 2020 Journal of Gastrointestinal Oncology. All rights reserved.
BACKGROUND: Recently, several studies have examined the association between preoperative sarcopenia and prognosis evaluation in patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. However, their conclusions remain ambiguous and controversial. Thus, we conducted a meta-analysis to assess the prognostic role of preoperative sarcopenia in patients with HCC undergoing hepatectomy. METHODS: We searched the existing literature reporting on the prognostic value of preoperative computed tomography (CT)-assessed sarcopenia for the survival of patients with HCC undergoing hepatectomy. The pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of overall survival (OS) and disease-free survival (DFS) were used to assess the prognostic value of preoperative sarcopenia in HCC patients. The associations between preoperative sarcopenia and clinicopathological characteristics were also evaluated. RESULTS: A total of six studies with 1,420 patients (including 458 sarcopenia and 962 non-sarcopenia patients) were included in the meta-analysis. The results showed that preoperative sarcopenia was significantly associated with poor OS (HR =1.572, 95% CI: 1.342-1.840, P=0) and shorter DFS (HR =1.544, 95% CI: 1.178-2.024, P=0.002) in patients with HCC undergoing hepatectomy. Preoperative sarcopenia was also significantly related to larger diameter tumors (WMD =0.598, 95% CI: 0.216-0.980, P=0.002). The results of the sensitivity analysis were stable in this meta-analysis. Egger's tests revealed that there was no significant publication bias. CONCLUSIONS: Sarcopenia appears to have significant adverse impacts on postoperative outcomes in patients with hepatocellular carcinoma following hepatectomy. However, further large-scale prospective studies are needed to confirm our findings. 2020 Journal of Gastrointestinal Oncology. All rights reserved.
Entities:
Keywords:
Preoperative sarcopenia; disease-free survival (DFS); hepatocellular carcinoma (HCC); overall survival (OS); skeletal muscle mass index (SMI)
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