文章：

局部晚期与局部复发性直肠癌中身体成分评估的意义与应用范围综述

A Scoping Review of the Implications and Applications of Body Composition Assessment in Locally Advanced and Locally Recurrent Rectal Cancer

原文发布日期：28 February 2025

DOI: 10.3390/cancers17050846

类型: Article

开放获取: 是

英文摘要：

Background: A strong body of evidence exists demonstrating deleterious relationships between abnormal body composition (BC) and outcomes in non-complex colorectal cancer. Complex rectal cancer (RC) includes locally advanced and locally recurrent tumours. This scoping review aims to summarise the current evidence examining BC in complex RC.Methods: A literature search was performed on Ovid MEDLINE, EMBASE, and Cochrane databases. Original studies examining BC in adult patients with complex RC were included. Two authors undertook screening and full-text reviews.Results: Thirty-five studies were included. Muscle quantity was the most commonly studied BC metric, with sarcopenia appearing to predict mortality, recurrence, neoadjuvant therapy outcomes, and postoperative complications. In particular, 10 studies examined relationships between BC and neoadjuvant therapy response, with six showing a significant association with sarcopenia. Only one study examined interventions for improving BC in patients with complex RC, and only one study specifically examined patients undergoing pelvic exenteration. Marked variation was also observed in terms of how BC was quantified, both in terms of anatomical location and how cut-off values were defined.Conclusions: Sarcopenia appears to predict mortality and recurrence in complex RC. An opportunity exists for a meta-analysis examining poorer BC and neoadjuvant therapy outcomes. There is a paucity of studies examining interventions for poor BC. Further research examining BC specifically in patients undergoing pelvic exenteration surgery is also lacking. Pitfalls identified include variances in how BC is measured on computed tomography and whether external cut-off values for muscle and adipose tissue are appropriate for a particular study population.

摘要翻译： 

背景：大量证据表明，异常身体成分（BC）与非复杂性结直肠癌患者预后之间存在有害关联。复杂性直肠癌（RC）包括局部晚期和局部复发性肿瘤。本范围综述旨在总结当前关于复杂性直肠癌中身体成分的研究证据。 方法：在Ovid MEDLINE、EMBASE和Cochrane数据库中进行文献检索。纳入针对成人复杂性直肠癌患者身体成分的原始研究。由两位作者独立完成文献筛选和全文审阅。 结果：共纳入35项研究。肌肉数量是最常研究的身体成分指标，肌肉减少症似乎能预测死亡率、复发率、新辅助治疗效果及术后并发症。特别值得注意的是，10项研究探讨了身体成分与新辅助治疗反应的关系，其中6项显示与肌肉减少症存在显著关联。仅有一项研究探讨了改善复杂性直肠癌患者身体成分的干预措施，仅有一项研究专门针对接受盆腔廓清术的患者。在身体成分的量化方法上，无论是解剖定位还是临界值的定义，均存在显著差异。 结论：肌肉减少症似乎能预测复杂性直肠癌患者的死亡率和复发风险。现有条件适合开展关于不良身体成分与新辅助治疗效果关系的荟萃分析。目前针对不良身体成分干预措施的研究严重不足，也缺乏专门针对接受盆腔廓清术患者身体成分的深入研究。已发现的方法学缺陷包括：计算机断层扫描中身体成分测量方式的差异，以及肌肉和脂肪组织的外部临界值是否适用于特定研究人群。

原文链接：

A Scoping Review of the Implications and Applications of Body Composition Assessment in Locally Advanced and Locally Recurrent Rectal Cancer