PDF(Pubmed)
Abstract：
OBJECTIVE: Numerous epidemiological investigations have explored the impact of body composition on the effectiveness of immune checkpoint inhibitors (ICIs) in urological malignancies (UM) patients, yielding conflicting findings. As a result, our study aims to elucidate the influence of baseline body composition on the long-term prognosis of UM patients treated with ICIs.
METHODS: We employed a rigorous systematic search across various databases, including PubMed, Embase, the Cochrane Library, and Google Scholar, to identify studies meeting our inclusion criteria. Our primary endpoints of interest encompassed overall survival (OS) and progression-free survival (PFS).
RESULTS: This analysis included a total of 10 articles with a combined patient cohort of 707 individuals. Our findings revealed a noteworthy association between several body composition parameters and unfavorable OS outcomes, including low psoas muscle index (PMI; HR: 3.88, p < 0.001), low skeletal muscle index (SMI; HR: 1.63, p < 0.001), sarcopenia (HR: 1.88, p < 0.001), low visceral adipose index (VAI; HR: 1.38, p = 0.018) and low subcutaneous adipose index (SAI; HR: 1.37, p = 0.018). Furthermore, our analysis demonstrated that low PMI (HR: 2.05, p = 0.006), low SMI (HR: 1.89, p = 0.002), sarcopenia (HR: 1.80, p < 0.001), and low VAI (HR:1.59, p = 0.005) were significantly correlated with inferior PFS. Conversely, SAI did not manifest a pronounced association with PFS in UM patients treated with ICIs.
CONCLUSIONS: Collectively, our study findings underscore a substantial relationship between baseline body composition and reduced clinical efficacy in UM patients undergoing ICI therapy.
METHODS: We employed a rigorous systematic search across various databases, including PubMed, Embase, the Cochrane Library, and Google Scholar, to identify studies meeting our inclusion criteria. Our primary endpoints of interest encompassed overall survival (OS) and progression-free survival (PFS).
RESULTS: This analysis included a total of 10 articles with a combined patient cohort of 707 individuals. Our findings revealed a noteworthy association between several body composition parameters and unfavorable OS outcomes, including low psoas muscle index (PMI; HR: 3.88, p < 0.001), low skeletal muscle index (SMI; HR: 1.63, p < 0.001), sarcopenia (HR: 1.88, p < 0.001), low visceral adipose index (VAI; HR: 1.38, p = 0.018) and low subcutaneous adipose index (SAI; HR: 1.37, p = 0.018). Furthermore, our analysis demonstrated that low PMI (HR: 2.05, p = 0.006), low SMI (HR: 1.89, p = 0.002), sarcopenia (HR: 1.80, p < 0.001), and low VAI (HR:1.59, p = 0.005) were significantly correlated with inferior PFS. Conversely, SAI did not manifest a pronounced association with PFS in UM patients treated with ICIs.
CONCLUSIONS: Collectively, our study findings underscore a substantial relationship between baseline body composition and reduced clinical efficacy in UM patients undergoing ICI therapy.
摘要：
目的：许多流行病学调查已经探讨了人体成分对泌尿系恶性肿瘤（UM）患者免疫检查点抑制剂（ICIs）有效性的影响，产生相互矛盾的发现。因此,本研究旨在阐明基线体成分对接受ICIs治疗的UM患者长期预后的影响.
方法：我们在各种数据库中进行了严格的系统搜索，包括PubMed,Embase,Cochrane图书馆,和谷歌学者，确定符合我们纳入标准的研究。我们感兴趣的主要终点包括总生存期（OS）和无进展生存期（PFS）。
结果：本分析共包括10篇文章和707名个体的合并患者队列。我们的发现揭示了几个身体成分参数与不良OS结果之间的显著关联，包括低腰肌指数（PMI；HR：3.88，p<0.001），低骨骼肌指数（SMI；HR：1.63，p<0.001），肌肉减少症（HR：1.88，p<0.001），低内脏脂肪指数(VAI;HR:1.38,p=0.018)和低皮下脂肪指数(SAI;HR:1.37,p=0.018)。此外，我们的分析表明，低PMI(HR：2.05，p=0.006)，低SMI（HR：1.89，p=0.002），肌肉减少症（HR：1.80，p<0.001），低VAI（HR：1.59，p=0.005）与低PFS显着相关。相反，在接受ICIs治疗的UM患者中，SAI与PFS没有明显的相关性。
结论：总的来说，我们的研究结果强调,在接受ICI治疗的UM患者中,基线体成分与临床疗效降低之间存在实质性关系.
方法：我们在各种数据库中进行了严格的系统搜索，包括PubMed,Embase,Cochrane图书馆,和谷歌学者，确定符合我们纳入标准的研究。我们感兴趣的主要终点包括总生存期（OS）和无进展生存期（PFS）。
结果：本分析共包括10篇文章和707名个体的合并患者队列。我们的发现揭示了几个身体成分参数与不良OS结果之间的显著关联，包括低腰肌指数（PMI；HR：3.88，p<0.001），低骨骼肌指数（SMI；HR：1.63，p<0.001），肌肉减少症（HR：1.88，p<0.001），低内脏脂肪指数(VAI;HR:1.38,p=0.018)和低皮下脂肪指数(SAI;HR:1.37,p=0.018)。此外，我们的分析表明，低PMI(HR：2.05，p=0.006)，低SMI（HR：1.89，p=0.002），肌肉减少症（HR：1.80，p<0.001），低VAI（HR：1.59，p=0.005）与低PFS显着相关。相反，在接受ICIs治疗的UM患者中，SAI与PFS没有明显的相关性。
结论：总的来说，我们的研究结果强调,在接受ICI治疗的UM患者中,基线体成分与临床疗效降低之间存在实质性关系.
