SynthesisFrontiers in nutrition2026
Pretreatment creatinine-to-cystatin c ratio as a prognostic marker in digestive tract cancers: a meta-analysis with reconstructed individual patient data and trial sequential analysis.
Synthesis in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Background: Sarcopenia, characterized by loss of skeletal muscle, is associated with unfavorable clinical outcomes in patients with cancer. The creatinine-to-cystatin C ratio (CCR) has emerged as a readily available marker related to muscle reserve. This meta-analysis aimed to examine the prognostic utility of baseline CCR levels in patients with digestive tract cancers. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library from database inception through 22 October 2025. Original cohort studies that enrolled adults with histologically proven digestive tract cancers, reported pretreatment CCR with overall survival hazard ratios, and classified patients using a specific CCR cut-off were included. Risk of bias was evaluated with the Newcastle-Ottawa Scale and the Quality in Prognostic Studies tool. Pooled hazard ratios for overall survival were synthesized. Patient-level survival data were reconstructed from published Kaplan-Meier curves. No original patient-level datasets were obtained from study investigators. Trial sequential analysis (TSA) was performed as an exploratory robustness assessment. Results: Nine independent cohorts comprising 3,073 patients were included. Lower CCR was significantly associated with shorter OS (HR = 1.71; 95% CI: 1.45-2.02; Conclusion: Pretreatment CCR was associated with overall survival in patients with digestive tract cancers. However, further prospective studies are needed to confirm these findings. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420261290556.
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