{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:01:57Z","timestamp":1792008117800,"version":"4.4.0"},"reference-count":48,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myosteatosis, a marker of fatty infiltration in skeletal muscle, has emerged as a potential prognostic factor in various cancers. However, its association with survival in patients with esophageal cancer (EC) or gastro-esophageal junction cancer (GEC) remains uncertain. This meta-analysis aimed to evaluate the predictive value of myosteatosis for survival of this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Embase, and Web of Science was conducted through May 14, 2025. Studies reporting overall survival (OS) and\/or progression-free survival (PFS) in patients with EC or GEC, with outcomes stratified by baseline myosteatosis status, were eligible for inclusion. To account for inter-study variability, pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were estimated using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven cohort studies comprising 1,810 patients with EC or GEC were included. Myosteatosis was significantly associated with poorer OS (HR = 1.46, 95% CI [1.13\u20131.88],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a076%). Subgroup analyses indicated consistent associations across study design, cancer type, age, sex, treatment modality, and analytic models (\n                      <jats:italic>p<\/jats:italic>\n                      for subgroup differences &gt; 0.05). A stronger effect was observed when myosteatosis was assessed using intramuscular adipose tissue content rather than muscle attenuation (HR = 2.29\n                      <jats:italic>vs.<\/jats:italic>\n                      1.30;\n                      <jats:italic>p<\/jats:italic>\n                      for subgroup difference = 0.02). Myosteatosis was not significantly associated with PFS (HR = 1.29, 95% CI [0.77\u20132.18],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.34;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a082%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Baseline myosteatosis is associated with poorer OS in patients with EC or GEC. Muscle quality assessment may improve prognostic stratification in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20825","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T08:49:27Z","timestamp":1771318167000},"page":"e20825","source":"Crossref","is-referenced-by-count":2,"title":["Association between myosteatosis and survival of patients with esophageal and gastro-esophageal junction cancer: a meta-analysis"],"prefix":"10.7717","volume":"14","author":[{"given":"Wu","family":"Wang","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Fujian Medical University, Fuzhou, China"},{"name":"Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinbiao","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianbao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, 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