Prognostic role of hand grip strength (HGS) on outcomes after gastrectomy for gastric cancer: a systematic review and meta-analysis
摘要
Gastric cancer (GC) is a prevalent malignancy with a substantial impact on public health. Muscle quality and function may serve as predictors of poor clinical outcomes in GC. The aim of this updated meta-analysis was to evaluate the prognostic significance of hand grip strength (HGS) in patients undergoing gastrectomy for GC.
MethodsA comprehensive literature search was conducted in PubMed, EMBASE, and Cochrane CENTRAL till August 2023, using keyword combinations of “hand grip strength”, “gastric resection”, and “gastrectomy”. Eligible studies were those focused on outcomes of GC patients undergoing gastrectomy, with a comparison of preoperative HGS. The primary outcome was overall survival (OS); postoperative complications were assessed as a secondary outcome. Newcastle–Ottawa scale was used for quality assessment.
ResultsNine studies involving 3,496 patients met our inclusion criteria, conducted primarily in China and Japan. A low HGS was significantly associated with worse OS (pooled adjusted hazard ratio [HR] = 2.29, 95% confidence interval [CI] 1.47–3.57) and increased postoperative complications (pooled adjusted odds ratio [OR] = 1.91, 95% CI 1.55–2.36). Sensitivity analysis confirmed the robustness of the results.
ConclusionsThis meta-analysis highlights the prognostic relevance of preoperative HGS in GC patients undergoing gastrectomy. The findings strongly link low HGS to decreased OS and postoperative complications risk. This relationship suggests the potential of HGS as a valuable marker for a preoperative risk assessment and stratification.