The correlation between high body mass index and survival in patients with esophageal cancer after curative esophagectomy: evidence from retrospective studies
Autor: | Wenbiao, Pan, Zhiyong, Sun, Yangwei, Xiang, Wentao, Fang |
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Rok vydání: | 2015 |
Předmět: | |
Zdroj: | Asia Pacific journal of clinical nutrition. 24(3) |
ISSN: | 0964-7058 |
Popis: | To investigate the predictive value of high body mass index (H-BMI) on the survival of patients with esophageal cancer (EC) after curative esophagectomy.Studies were systematically identified to investigate the relationship between overweight and obese (H-BMI) and clinical outcomes in EC patients treated with curative esophagectomy. Measured clinical outcomes were disease-free survival (DFS) and overall survival (OS). The pooled hazard ratio (HR) with 95% confidence interval (CI) was estimated. Subgroup analyses were performed according to tumour type and body mass index (BMI).Fourteen studies with 4823 cases were included in the final pooled quantitative analysis. In EC patients overall, H-BMI was associated with improved DFS (HR, 0.83; 95% CI: 0.75-0.90) and OS (HR, 0.79; 95 % CI: 0.73-0.85), as compared with normal BMI. The results were consistent with those who were overweight. Among patients with esophageal adenocarcinoma (EAC), a better prognosis, as reflected by OS, was observed with H-BMI (HR, 0.81; 95% CI: 0.73-0.89). The same results were also observed in EAC patients who were obese and overweight. In contrast, among patients with esophageal squamous cell carcinoma (ESCC), H-BMI was associated with a worse prognosis, as reflected by DFS (HR, 2.26; 95% CI: 1.29-3.24).H-BMI has distinctly different impacts on the postoperative survival of EAC and ESCC patients. H-BMI is a potential predictor for better prognosis in EC patients overall, and particularly in EAC patients, treated with curative esophagectomy. However, in ESCC patients, H-BMI is a potential predictor for a worse prognosis of postoperative survival.目的:探讨食管癌患者术前高体重指数(high body mass index,H-BMI)对 食管癌根治性切除术后长期生存的影响及其预测价值。方法:通过系统、全 面的文献检索,收集已公开发表的有关食管癌患者术前H-BMI(包括超重和 肥胖)对术后生存期影响的所有临床研究,按累计定量分析的要求对检索到 的原始研究的质量进行评估,对符合条件的所有研究结果进行累计定量分 析,计算数据合并后的H-BMI 对正常BMI 的危险比(hazard ratio,HR)及 95% 置信区间(confidence interval,CI) ,并根据体重指数(body mass index,BMI)及食管癌亚型进行亚组分析,评价术前H-BMI 对食管癌患者根 治性切除术后生存期的影响。结果:共14 篇文献符合纳入标准,总样本量 4823 例。累计定量分析结果表明,H-BMI 改善了总体食管癌患者术后无疾病 生存率( disease-free survival , DFS ) 和总体生存率( Overall survival , OS),合并的HR 分别为0.83(95% CI: 0.75-0.90)和0.79(95% CI: 0.73- 0.85);在亚组分析的超重患者中也得出了相似结果。根据肿瘤亚型进一步 分层分析发现,H-BMI 显著改善了食管腺癌患者术后OS,合并的HR 为0.81 (95% CI: 0.73-0.89),在超重和肥胖的亚组分析中也得出了相似的结果。然 而在食管鳞癌中,术前H-BMI 缩短了患者术后DFS,合并的HR 为2.26 (95% CI: 1.29-3.24)。结论:H-BMI 对食管鳞癌和食管腺癌患者术后长期生 存的影响完全不同。H-BMI 是食管癌总体、特别是食管腺癌术后生存预后较 佳的一个潜在性预测指标,而对食管鳞癌来说,H-BMI 则预示着较差的术后 生存。. |
Databáze: | OpenAIRE |
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