Impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer: a systematic review and meta-analysis.

Background: Sarcopenia and sarcopenic obesity are associated with an increased possibility of adverse clinical outcomes; however, the effects of sarcopenia and sarcopenic obesity on patients with primary liver cancer remain controversial. Therefore, the present study aimed to determine the impact of sarcopenia and sarcopenic obesity on survival in patients with primary liver cancer. Methods: We searched studies published in English in PubMed, Embase, Web of Science, and Cochrane Library databases up to 13 November 2022. Cohort studies that reported the association among sarcopenia, sarcopenic obesity, and patient survival were included. Results: A total of 64 cohort studies with data on 11,970 patients with primary liver cancer were included in the meta-analysis. Sarcopenia was associated with poor overall survival in patients with primary liver cancer [adjusted hazard ratio (HR) 2.11, 95% confidence interval (CI): 1.89-2.36, P < 0.0001], with similar findings for sarcopenic obesity (adjusted HR: 2.87, 95% CI: 2.23-3.70, P < 0.0001). Sarcopenia was also associated with poor overall survival across the subgroups analyzed by ethnicity, type of liver cancer, treatment modalities, method used to define sarcopenia, and etiology of liver cancer. We also found a negative correlation among sarcopenia, sarcopenic obesity, and recurrence-free/disease-free survival (adjusted HR: 1.73, 95% CI: 1.50-1.99, P < 0.001; adjusted HR: 2.28, 95% CI: 1.54-3.35, P < 0.001, respectively). Conclusion: Sarcopenia and sarcopenic obesity were significantly associated with poor overall survival and recurrence-free/disease-free survival in patients with primary liver cancer. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378433, PROSPERO [42022378433].

Clinical research on the combined use of systemic chemotherapy and CT-guided radiofrequency ablation in treatment of lung cancer.

The purpose of this study is to describe the clinical efficacy and safety of the combined use of systemic chemotherapy and CT-guided radiofrequency ablation (RFA) in treatment of lung cancer. A panel of 256 patients with lung cancer who were admitted to our hospital from June 2017 to October 2019 were recruited. According to the treatment plan, the patients were divided into test group (n = 128) and control group (n = 128). Patients in the test group were treated by systemic chemotherapy combined with CT-guided RFA, while patients in the control group were given systemic chemotherapy only. After treatment, a comparative analysis was conducted in terms of clinical efficacy, level of tumor markers, and adverse reactions. Meanwhile, patients in the two groups were followed up for analysis of progression-free survival (PFS) and overall survival (OS). After treatment, the tumor objective response rate and disease control rate of patients in the test group were significantly higher than those in the control group. Besides, in patients of the test group, tumor markers, such as serum carcino-embryonic antigen, neuro-specific enolase, cytokeratin-19, and carbohydrate antigen-199, presented a remarkably lower level relative to those in the control group (p < 0.05). However, there was no significant difference observed with regard to the incidence of complications (p > 0.05). Additionally, patients in the test group were more likely to have better PFS and OS. Notably, we monitored that in the test group, superior clinical efficacy was achieved in patients with non-small cell lung cancer and lung adenocarcinoma relative to that in patients with small cell lung cancer and lung squamous cell carcinoma, respectively. The combined use of systemic chemotherapy and CT-guided RFA can produce good clinical efficacy in treatment of lung cancer. It is relatively safe and deserves promotion and application in clinic.

Clinical Research on Systemic Chemotherapy Combined With Bronchoscopic Seed Implantation in the Treatment of Advanced Lung Cancer.

OBJECTIVE: This study aims to explore the clinical value of systemic chemotherapy combined with bronchoscopic seed implantation in advanced lung cancer treatment. METHODS: The study enrolled 253 patients with advanced lung cancer in Cangzhou People's Hospital from March 2018 to March 2020, and they were divided into test group and control group. Test group was given systemic chemotherapy combined with bronchoscopic seed implantation, while control group was given systemic chemotherapy. The objective response rate of tumor (ORR), disease control rate (DCR), serum tumor marker level, survival time and adverse reactions of 2 groups were compared. RESULTS: After treatment, the levels of serum tumor markers including carcino-embryonic antigen, neuro-specific enolase, cytokeratin-19 and pro-gastrin-releasing peptide were markedly decreased in test group compared with those in control group (P < 0.05). Therein, the serum tumor marker level of non-small cell lung cancer (NSCLC) patients was significant decreased compared with that of small cell lung cancer (SCLC) patients in test group. Meanwhile, in test group, the serum tumor marker level of lung adenocarcinoma (LUAD) patients was significant decreased compared with that of lung squamous cell carcinoma (LUSC, P < 0.05). The ORR and DCR in test group were superior to those in control group (63.4%, 92.5% vs 38.7%, 72.3%, P < 0.05), while those were much higher in patients with NSCLC and LUAD relative to those in patients with SCLC and LUSC, respectively (P < 0.05). Furthermore, the progression-free survival (PFS) and overall survival (OS) in test group were significantly greater than those in control group. In test group, the PFS and OS of patients with NSCLC and LUAD were higher than those of patients with SCLC and LUSC. CONCLUSION: The efficacy of systemic chemotherapy combined with bronchoscopic seed implantation was superior to that of systemic chemotherapy, which is worthy of promoting in clinical practice.

Clinical study of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer.

BACKGROUND: This study is designed to investigate the clinical value of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer. METHODS: A total of 412 lung cancer patients admitted to Cangzhou People's Hospital from March 2018 to March 2020 were collected and divided into test group and control group based on their treatment schedules. The test group received systemic chemotherapy combined with bronchoscopic interventional cryotherapy, while the control group received systemic chemotherapy alone. Tumor objective response rate (ORR), disease control rate (DCR), serum tumor marker levels, serum matrix metalloproteinase (MMP) content, T cell subset level, survival time and adverse reactions of the two groups were observed. RESULTS: The ORR and DCR of the test group were better than those of the control group, while those of the non-small cell lung cancer (NSCLC) patients in the test group were better than patients with small-cell lung cancer (SCLC) (P <  0.05). There was no significant difference in serum tumor marker levels, MMP content and T cell subset level between the two groups before treatment. After treatment, the serum tumor marker levels along with serum MMP-2, MMP-9 and CD8+ levels in the test group decreased more remarkably, while CD4+ and CD4+/CD8+ levels increased more significantly than those in the control group (P <  0.05). The serum MMP-2 and MMP-9 of NSCLC patients in the test group decreased more remarkably than those of SCLC patients, while there was no significant difference in CD8+, CD4+ and CD4+/CD8+. The progression-free survival and overall survival of the test group were obviously longer than those of the control group. The same trend was observed in NSCLC patients compared with SCLC patients in the test group (P <  0.05). CONCLUSIONS: Systemic chemotherapy combined with bronchoscopic interventional cryotherapy for lung cancer has good clinical efficacy and safety, and can be widely used in clinical practice.