Clinical implications of sarcopenia in patients undergoing complete resection for early non-small cell lung cancer

Lung Cancer. 2016 Nov:101:92-97. doi: 10.1016/j.lungcan.2016.08.007. Epub 2016 Aug 16.

Abstract

Objectives: Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength. We aimed to investigate sarcopenia in patients with stage I non-small cell lung cancer (NSCLC) who underwent complete resection, and the relationship of sarcopenia with clinicopathological factors.

Methods: All consecutive patients who underwent lung resection between January 2005 and December 2008 were enrolled in this retrospective study. Eligible patients were assigned to one of 2 groups according to the presence or absence of sarcopenia, as assessed by the sum of cross-sectional areas of skeletal muscles in the region of the third lumbar vertebra (L3) on preoperative computed tomography (CT).

Results: Sixteen of 52 male (30.8%) and 22 of 38 female (57.9%) patients were identified with sarcopenia (p=0.01). Patients with sarcopenia were more likely to have a low body mass index (BMI) (p<0.0001). Kaplan-Meier analysis showed that patients with sarcopenia had a significantly worse outcome than patients without sarcopenia (5-year-survival: 72.8% vs 85.8%, respectively, p=0.028). Multivariate analysis found that sarcopenia was a significant independent prognostic factor (hazard ratio: 7.09, p=0.0008).

Conclusions: Sarcopenia identified on a cross-sectional CT image of the L3 level was associated with poor outcome with completely resected early-stage NSCLC.

Keywords: Computed tomography; Non-small cell lung cancer; Prognosis; Sarcopenia.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Muscle, Skeletal / diagnostic imaging*
  • Muscle, Skeletal / pathology
  • Neoplasm Staging
  • Outcome Assessment, Health Care
  • Prognosis
  • Retrospective Studies
  • Sarcopenia / complications*
  • Sarcopenia / diagnostic imaging*
  • Sarcopenia / physiopathology
  • Survival Analysis
  • Tomography, X-Ray Computed / methods