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Prognostic value of myosteatosis in patients with lung cancer: a systematic review and meta-analysis

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Abstract

The prognostic value of myosteatosis has been widely investigated in lung cancer, yet conclusions remain controversial. The purpose of this meta-analysis was to illuminate this issue. Medline, Embase, Cochrane Library and Web of Science Core Collection online databases were systematically searched from inception to 24 September 2021. Newcastle–Ottawa Scale tool was applied to evaluate the quality of included studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS) were used to examine prognostic value of myosteatosis. Subgroup analysis and sensitivity analysis were conducted to assess heterogeneity and stability of results. A total of 484 articles were screened from which 9 eligible studies involving 1667 patients were enrolled in this meta-analysis. Lung cancer patients with myosteatosis had significantly worse OS than patients without myosteatosis (HR 1.10, 95% CI 1.05–1.16, P < 0.001), both in six multivariate analysis (HR 1.46, 95% CI 1.16–1.85, P = 0.001) and in three univariate analysis (HR 1.08, 95% CI 1.03–1.14, P = 0.003). Pooled data from five studies using multivariate survival analysis also showed that patients with myosteatosis had a statistically significant unfavorable PFS (HR = 1.27, 95% CI 1.00–1.62, P = 0.049). Sensitivity analysis showed the result for OS was stable. But for PFS, the result was not robust. Myosteatosis might serve as an independent indicator of unfavorable survival outcomes for OS and PFS in lung cancer patients. Further studies are needed to confirm our results.

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Funding

This study was funded by Nanjing Medical science and technology development Foundation (Grant number ZKX17024).

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Authors and Affiliations

  1. School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, China

    Shaofang Feng, Huiwen Mu & Yubing Zhu

  2. Department of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China

    Shaofang Feng, Huiwen Mu, Yunxin Liu, Zheng Zhao & Yubing Zhu

  3. School of Medical Imaging, Shanxi Medical University, Taiyuan, 030000, China

    Rong Hou

  4. Department of Clinical Pharmacology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China

    Jianjun Zou

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  1. Shaofang Feng
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  4. Yunxin Liu
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Contributions

SF performed the study, analyzed the dada, and wrote the manuscript. HM and RH collected the data. YL and JZ carried out additional data analysis. ZZ and YZ contributed to the study design and were responsible for the revision and submission of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Zheng Zhao or Yubing Zhu.

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Feng, S., Mu, H., Hou, R. et al. Prognostic value of myosteatosis in patients with lung cancer: a systematic review and meta-analysis. Int J Clin Oncol 27, 1127–1138 (2022). https://doi.org/10.1007/s10147-022-02181-1

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