Sarcopenia is related to poor prognosis in patients after trimodality therapy for locally advanced non-small cell lung cancer

• Published in: International journal of clinical oncology Vol. 26; no. 8; pp. 1450 - 1460
• Main Authors: Katsui, Kuniaki, Ogata, Takeshi, Watanabe, Kenta, Yoshio, Kotaro, Kuroda, Masahiro, Yamane, Masaomi, Hiraki, Takao, Kiura, Katsuyuki, Toyooka, Shinichi, Kanazawa, Susumu
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.08.2021; Springer Nature B.V
• Subjects: Body composition; Body fat; Body mass; Cancer Research; Chemoradiotherapy; Computed tomography; Lung cancer; Medical prognosis; Medicine; Medicine & Public Health; Multivariate analysis; Non-small cell lung carcinoma; Oncology; Original Article; Patients; Prognosis; Psoas muscle; Sarcopenia; Small cell lung carcinoma; Surgery; Surgical Oncology; Vertebrae; Neoadjuvant therapy; Sarcopenia; Thoracic surgery; Adipose tissue; Non-small-cell lung carcinoma
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-021-01927-7

Background The association between sarcopenia and prognosis in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing trimodality therapy, consisting of preoperative concurrent chemoradiotherapy and surgery, has not been reported. Therefore, we aimed to investigate the association of sarcopenia and fat mass with prognosis after trimodality therapy. Methods To assess sarcopenia, the psoas muscle mass was measured. Using computed tomography data, including third lumbar vertebra level images, psoas muscle mass and visceral and subcutaneous fat mass were measured. Additionally, body mass indices, and visceral/subcutaneous fat ratio, obtained by dividing the visceral fat index by the subcutaneous fat index, were calculated. We investigated the relationship between these parameters and overall survival. Results Ninety-nine eligible patients were included. In the univariate analysis, age, clinical stage, tumor location, psoas muscle index, and visceral/subcutaneous fat ratio were significant prognostic factors for overall survival ( P  = 0.008, P  = 0.04, P  = 0.04, P  = 0.02, and P  = 0.02, respectively). In the multivariate analysis, age and psoas muscle index were significant prognostic factors for overall survival ( P  = 0.01 and P  = 0.03, respectively). The 5-year overall survival rates for the high and low psoas muscle index groups were 79.6% [95% confidence interval (CI), 67.1–94.5%] and 66.2% (95% CI, 54.1–81.1%), respectively; whereas, the 10-year overall survival rates were 61.9% (95% CI, 42.0–91.4%) and 25.3% (95% CI, 8.6–74.2%), respectively. Conclusion Sarcopenia was related to poor overall survival in patients with locally advanced NSCLC undergoing trimodality therapy. Assessment of body composition prior to treatment may provide important information for formulating rational therapeutic strategies.