The impact of myosteatosis on the outcomes of digestive malignancies has gained great attention recently. However, studies on the impact of myosteatosis show inconsistent results. We conducted a meta-analysis to clarify the relationship between myosteatosis and the overall survival of digestive cancer patients. The systematic literature search was conducted on PubMed/MEDLINE, Web of Science, and Embase from inception through March 27, 2021. Meta-analysis was performed using the random-effects model. Out of 3451 studies screened, 47 studies including 21,194 patients passed the screening criteria. The average prevalence of myosteatosis was 46.4%. Patients with myosteatosis had 44% increased mortality risk compared with non–myosteatosis patients (HR: 1.44, 95% CI: 1.33-1.55, P < .05). The predictive value of myosteatosis held regardless of country zone, study design, statistical model, Newcastle-Ottawa Scale (NOS) scores, treatment, sample size, and tumor stage. Nevertheless, the predictive value of myosteatosis was only evident for patients with esophagogastric cancers, cholangiocarcinoma/pancreatic cancers, or colorectal cancers. Overall, the results of this meta-analysis were robust based on sensitivity, subgroup, meta-regression, and trial sequential analyses and suggested that myosteatosis predicted worse overall survival (OS) in digestive malignancies patients.

肌肉脂肪变性对消化系统恶性肿瘤结果的影响最近引起了极大的关注。然而，关于肌肉脂肪变性影响的研究显示出不一致的结果。我们进行了一项荟萃分析，以阐明肌肉脂肪变性与消化道癌症患者总生存率之间的关系。从开始到 2021 年 3 月 27 日，在 PubMed/MEDLINE、Web of Science 和 Embase 上进行了系统的文献检索。使用随机效应模型进行了荟萃分析。在筛选的 3451 项研究中，47 项研究（包括 21,194 名患者）通过了筛选标准。肌肉脂肪变性的平均患病率为 46.4%。与非肌肉脂肪变性患者相比，肌肉脂肪变性患者的死亡风险增加了 44%（HR：1.44，95% CI：1.33-1.55，P< .05）。无论国家区域、研究设计、统计模型、纽卡斯尔-渥太华量表 (NOS) 评分、治疗、样本大小和肿瘤分期如何，肌肉脂肪变性的预测价值都保持不变。然而，肌肉脂肪变性的预测价值仅对食管胃癌、胆管癌/胰腺癌或结直肠癌患者具有明显的预测价值。总体而言，基于敏感性、亚组、荟萃回归和试验序贯分析，该荟萃分析的结果是可靠的，并表明肌肉脂肪变性预测消化系统恶性肿瘤患者的总生存期 (OS) 较差。