The prognostic impact of myosteatosis on overall survival in gynecological cancer patients: A meta‐analysis and trial sequential analysis. Issue 11 (30th June 2022)

• Record Type: Journal Article
• Authors: Cao, Hongyi; Gong, Yang; Wang, Yue
• Is Part Of: International journal of cancer. Volume 151:Issue 11(2022)
• Page Start: 1997
• Page End: 2003
• Publication Date: 2022-06-30
• Subjects: body composition -- gynecological cancer -- myosteatosis -- overall survival -- prognosis; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34179
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Myosteatosis is a novel imaging biomarker for survival in gynecological cancer patients; however, the evidence is inconsistent. This meta‐analysis aims to investigate the impact of myosteatosis on overall survival in the gynecological oncology setting. Three databases (PubMed, EMBASE and Web of Science) were systematically searched for relevant literature up to October 30, 2021. A random‐effects model was used to evaluate the predictive effect of myosteatosis on overall survival in the gynecological cancer population. The Newcastle‐Ottawa Scale was used to assess the methodological quality of the included studies. Trial sequential analysis was used to control the risk of random errors. Twelve studies with a total of 2519 patients were included. Myosteatosis was associated with a 50% increased mortality risk (HR 1.50, 95% CI 1.24‐1.82, P < .001) in gynecological cancer patients. Subgroup analyses stratified by study design, statistical model, treatment, sample size and stage confirmed the predictive value of myosteatosis on survival. However, the prognostic ability of myosteatosis only was held in the American and European populations but lost in Asians. Additionally, myosteatosis was not associated with the increased mortality in endometrial and cervical cancers, except for ovarian cancers. Overall, myosteatosis is a powerful predictor of reduced overall survival in gynecological cancer patients. Abstract : What's new? Losses in muscle mass and muscle quality, known respectively as sarcopenia and myosteatosis, are promising biomarkers of survival in gynecological cancer. Myosteatosis is of particular interest, since it develops before sarcopenia and is prevalent in patients with gynecological cancer. The present meta‐analysis examined the predictive effect of myosteatosis on overall survival among gynecological cancer patients, finding that myosteatosis effectively predicts reduced overall survival. Among patients diagnosed with myosteatosis, analyses revealed a 50% increase in mortality risk. The findings suggest that myosteatosis is an effective prognostic biomarker for patients with gynecologic cancer and could inform personalized treatment and patient care.