Skeletal muscle area predicts the outcomes of non-small-cell lung cancer after trimodality therapy. Issue 2 (25th January 2023)

• Record Type: Journal Article
• Authors: Watanabe, Kenji; Kinoshita, Fumihiko; Takenaka, Tomoyoshi; Nagano, Taichi; Oku, Yuka; Kosai, Keisuke; Ono, Yuki; Haratake, Naoki; Kohno, Mikihiro; Kamitani, Takeshi; Yoshitake, Tadamasa; Okamoto, Tatsuro; Shimokawa, Mototsugu; Ishigami, Kousei; Yoshizumi, Tomoharu
• Is Part Of: Interdisciplinary cardiovascular and thoracic surgery. Volume 36:Issue 2(2023)
• Publication Date: 2023-01-25
• Subjects: Lung cancer -- Neoadjuvant chemoradiotherapy -- Sarcopenia -- Skeletal muscle
• DOI: 10.1093/icvts/ivad020
• Languages: English
• ISSNs: 2753-670X

Abstract

Abstract: OBJECTIVES: Sarcopenia correlates with poor prognosis in various malignancies. However, the prognostic significance of sarcopenia remains to be determined in patients with non-small-cell lung cancer who undergo surgery after receiving neoadjuvant chemoradiotherapy (NACRT). METHODS: We retrospectively reviewed the patients with stage II/III non-small-cell lung cancer who underwent surgery following NACRT. The paravertebral skeletal muscle area (SMA) (cm 2 ) at the 12th thoracic vertebra level was measured. We calculated the SMA index (SMAI) as SMA/squared height (cm 2 /m 2 ). Patients were divided into low and high SMAI groups, and the association of SMAI with clinicopathological factors and prognosis was assessed. RESULTS: The patients' [men, 86 (81.1%)] median age was 63 (21–76) years. There were 106 patients including 2 (1.9%), 10 (9.4%), 74 (69.8%), 19 (17.9%) and 1 (0.9%) patients with stage IIA, IIB, IIIA, IIIB and IIIC, respectively. Of the patients, 39 (36.8%) and 67 (63.2%) were classified in the low and the high SMAI groups, respectively. Kaplan–Meier analysis showed that the low group had a significantly shorter overall survival and disease-free survival than the high group. Multivariable analysis identified low SMAI as an independent poor prognostic factor for overall survival. CONCLUSIONS: Pre-NACRT SMAI correlates with poor prognosis; therefore, assessing sarcopenia based on pre-NACRT SMAI may help determine optimal treatment strategies and suitable nutritional and exercise interventions. Abstract : Lung cancer continues to be one of the most common leading causes of cancer-related death worldwide [1].