Prognostic values of myosteatosis for overall survival in patients with gastric cancers: A meta-analysis with trial sequential analysis

Gastric cancer is among the most common and lethal cancers worldwide. Recently, studies have reported that myosteatosis is a prognosticator for adverse survival outcomes in patients with gastric cancer, but with inconsistent conclusions. Therefore, this meta-analysis aimed to systematically quantify the predictive power of myosteatosis for overall survival in the gastric cancer setting. A systematic literature earch was conducted based on three databases (PubMed/Medline, EMBASE, and Web of Science) from inception until November 30, 2021. This meta-analysis pooled the hazard ratios and their 95% confidence intervals of mortality risk in patients with gastric cancer with myosteatosis versus nonmyosteatosis using a fixed-effects model. Twelve studies of 5904 patients were included. Myosteatosis was associated with higher mortality risk (hazard ratio: 1.46; 95% confidence interval, 1.32–1.61; P < 0.001; I2 = 23.8%) in the gastric cancer setting. The results of the subgroup analysis revealed that patients with myosteatosis undergoing surgery had significantly shortened overall survival. Overall, the results of this meta-analysis are robust to sensitivity and trial sequential analyses. Myosteatosis was identified as a strong predictor of reduced overall survival in the gastric cancer population.