Supplementary Material for: CT-defined fat composition as a prognostic marker in gastric adenocarcinoma: a systematic review and meta-analysis.

Background: Computed tomography (CT)-defined fat quantification has been an emergent field of research in oncology. It was shown that this parameter is predictive and prognostic of several clinically relevant factors in several tumor entities. Objective: Our aim was to establish the effect of visceral and subcutaneous fat areas on overall survival (OS), disease-free survival (DFS), and postoperative complications in gastric cancer patients based on a large patient sample. Methods: MEDLINE library, EMBASE and SCOPUS databases were screened for the associations between visceral (VFA) and subcutaneous fat areas (SFA) defined by CT images and OS, DFS, and postoperative complications in gastric cancer patients up to August 2022. The primary endpoint of the systematic review was the hazard ratio for the outcome parameters. In total, 9 studies were suitable for the analysis and included into the present study. Results: The included studies comprised 3713 patients. The identified frequency of visceral obesity was 44.9%. The pooled hazard ratio for the effect of high VFA on OS was 1.28 (95% CI 1.09-1.49, p=0.002). For SFA, it was 1.87 (95% CI 1.45-2.42, p<0.0001). The pooled hazard ratio for the influence of high VFA on DFS was 1.17 (95% CI 0.95-1.43, p=0.14). The pooled odds ratio for the associations between VFA and postoperative complications was 1.36 (95% CI 1.09-1.69, p=0.006). Conclusion: CT-defined visceral and subcutaneous fat areas influence overall survival in patients with gastric cancer. VFA influences also occurrence of postoperative complications. Therefore, assessment of fat areas should be included into clinical routine in patients with gastric cancer.

背景：计算机断层扫描（CT）定义的脂肪定量分析是肿瘤学领域的新兴研究方向。已有研究表明，该指标可对多种肿瘤类型中的多项临床相关因素起到预测与预后评估作用。
目的：本研究旨在基于大样本患者队列，明确内脏脂肪面积（VFA）与皮下脂肪面积（SFA）对胃癌患者总生存期（OS）、无病生存期（DFS）及术后并发症的影响。
方法：本研究检索了MEDLINE、EMBASE及SCOPUS数据库，筛选截至2022年8月发表的、关于计算机断层扫描（CT）定义的内脏脂肪面积（VFA）与皮下脂肪面积（SFA）和胃癌患者OS、DFS及术后并发症相关性的文献。本系统评价的主要终点为各结局指标的风险比。最终共有9项符合分析标准的研究被纳入本研究。
结果：纳入研究共涉及3713例患者。经统计，内脏肥胖的检出率为44.9%。高VFA对OS影响的合并风险比为1.28（95%置信区间[CI]：1.09~1.49，P=0.002）；高SFA对应的合并风险比为1.87（95%CI：1.45~2.42，P<0.0001）。高VFA对DFS影响的合并风险比为1.17（95%CI：0.95~1.43，P=0.14）。VFA与术后并发症相关性的合并比值比为1.36（95%CI：1.09~1.69，P=0.006）。
结论：CT定义的内脏与皮下脂肪面积可影响胃癌患者的总生存期；内脏脂肪面积还会对术后并发症的发生产生影响。因此，胃癌患者的临床诊疗常规中应纳入脂肪面积评估环节。

搜集汇总

背景与挑战

背景概述

该数据集是胃癌患者CT定义脂肪组成与预后关系的系统综述和荟萃分析的补充材料，包含3713名患者数据，证实内脏和皮下脂肪区域对总生存期及术后并发症有显著影响。