Prevalence and prognostic value of sarcopenia in patients with bladder cancer undergoing radical cystectomy: a systematic review and meta-analysis
Bibliographic record
Abstract
Background The relationship between sarcopenia and clinical outcomes in patients with bladder cancer (BC) has been inconsistently reported in the literature. Some studies have identified sarcopenia as a potential prognostic indicator associated with reduced survival following radical cystectomy (RC). Objectives This study was conducted to systematically evaluate the prognostic significance of sarcopenia in patients with bladder cancer undergoing RC. Design Systematic review and meta-analysis. Methods We conducted a comprehensive search of multiple databases, including PubMed, EMBASE, Web of Science, Cochrane Library, CHINAHL, China National Knowledge Infrastructure (CNKI) Databases, and Wanfang Database, up to August 23, 2023, to identify both retrospective and prospective cohort studies. To assess the methodological quality of the included studies, the Newcastle-Ottawa Scale was utilized to evaluate the risk of bias. Furthermore, heterogeneity and potential publication bias were examined, and both subgroup and sensitivity analyses were performed to ensure the robustness of the findings. Results A total of 18 studies comprising 3,110 patients were included in the quantitative synthesis. The results of meta-analysis showed that the pooled prevalence of sarcopenia was estimated to be 49% (95% CI: 41% to 57%, I2 = 95.3%, P < 0.001), which was based on a random-effects model. We observed that BC patients with sarcopenia had a worse OS (HR:1.64, 95% CI: 1.30 to 1.97, I2 = 76.5%, P < 0.001} and CSS (HR:1.86, 95% CI: 1.45 to 2.27, I2 = 0.0%, P < 0.001). Conclusion Sarcopenia is commonly observed among patients with bladder cancer and appears to be an important prognostic indicator associated with decreased OS and CSS in those undergoing radical cystectomy. Further prospective studies are warranted to validate these findings. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD42023456724.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.046 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".