Preoperative thoracic muscle area on computed tomography predicts long-term survival following pneumonectomy for lung cancer

Troschel, Fabian M.; Kuklinski, Martin W.; Knoll, Sheila J.; Best, Till D.; Muniappan, Ashok; Gaissert, Henning A.; Fintelmann, Florian J.

doi:10.1093/icvts/ivy280

Cited by 21 publications

(26 citation statements)

References 29 publications

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“…A one-week ski-based exercise is known to improve balance in recreational skiers [30], a key challenge in brain tumor patients [26]. Given that, in prostate cancer, exercise was even able to reverse loss of muscle [31], with muscle being key to survival in several cancer entities [32][33][34], the implementation of challenging exercise might even have implications for survival.…”

Section: Effects On Activity and Future Implicationsmentioning

confidence: 99%

Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study

Troschel

Ramroth

Lemcke

et al. 2020

JCM

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A brain tumor diagnosis poses a significant psychological burden and it severely impacts quality of life (QOL), both in patients and relatives. However, comprehensive strategies addressing QOL in this setting remain rare. Here, we aim to share our findings of a one-week ski exercise intervention, with emphasis on feasibility, safety, QOL, and physical exercise. The intervention consisted of week-long daily ski sessions with professional ski guides as well as dedicated physicians present. The participants were handed questionnaires, including distress and QOL items before, during, and after the intervention. Using fitness watches, exercise intensity was also tracked at these timepoints. During the intervention, patients were checked for adverse events daily. Fifteen participants, nine patients after multidisciplinary treatment, and six relatives were included in the study. Additionally, 13 children participated in the exercise, but not in the study. All of the participants completed the entire program. No severe adverse events were documented during daily checks. There was a strong increase in quantified activity and QOL with a corresponding decrease in distress during the intervention, and, partly, afterwards. This prospective brain tumor rehabilitation study demonstrates the feasibility and safety of challenging ski exercise in brain tumor patients. The findings also underline the exercise-mediated QOL benefits, emphasizing the need for more comprehensive brain tumor rehabilitation programs.

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Section: Effects On Activity and Future Implicationsmentioning

confidence: 99%

Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study

Troschel

Ramroth

Lemcke

et al. 2020

JCM

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“…In multivariable Cox proportional hazard regression models adjusted for parameters known to be associated with survival, sarcopenia was independently associated with cancer‐specific survival (hazard ratio [HR] 1.74, p = 0.008) and overall survival (HR 1.68, p = 0.003; Table 2 for CSS, Table for OS) 2,5,13,19–22 …”

Section: Resultsmentioning

confidence: 99%

“…Psoas muscle area on preoperative abdominal CT has also been linked to OS in patients with lung cancer in a single‐center study 12 . Our own single‐center study provided preliminary data suggesting that muscle area on chest CT at the level of T8 was also associated with OS following pneumonectomy but relied on a cohort‐specific cutoff value 13 . A bi‐institutional study investigating overall mortality following various anatomic and non‐anatomic resections for lung cancer failed to uncover direct correlations between muscle area and survival and relied on a “morphometric index” with a cohort‐specific cutoff value 29 …”

Section: Discussionmentioning

confidence: 97%

“…The explanatory variable was sarcopenia defined as muscle CSA at T10 two standard deviations below the mean of a healthy reference group reported by Derstine et al 9 We also explored associations with continuous muscle CSA (in 10 cm² steps) at T8, T10, and T12 13,15,18 …”

Section: Methodsmentioning

confidence: 99%

“…Current evidence supporting low muscle mass as a predictor of early death after lung resection is predominantly based on single‐center cohorts of patients who underwent lobectomy, a less mortal, and morbid procedure compared to pneumonectomy 11 . An association of OS after pneumonectomy with psoas muscle mass at the level of the third lumbar vertebra (L3) and thoracic muscle mass has been reported in two single‐center cohorts of about 150 patients each 12,13 . However, sarcopenia on chest CT based on externally validated cut‐off values and the link with cancer‐specific survival (CSS) have not been previously investigated in the context of pneumonectomy for NSCLC.…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenia on preoperative chest computed tomography predicts cancer‐specific and all‐cause mortality following pneumonectomy for lung cancer: A multicenter analysis

et al. 2021

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Background Mortality risk prediction in patients undergoing pneumonectomy for non‐small cell lung cancer (NSCLC) remains imperfect. Here, we aimed to assess whether sarcopenia on routine chest computed tomography (CT) independently predicts worse cancer‐specific (CSS) and overall survival (OS) following pneumonectomy for NSCLC. Methods We included consecutive adults undergoing standard or carinal pneumonectomy for NSCLC at Massachusetts General Hospital and Heidelberg University from 2010 to 2018. We measured muscle cross‐sectional area (CSA) on CT at thoracic vertebral levels T8, T10, and T12 within 90 days prior to surgery. Sarcopenia was defined as T10 muscle CSA less than two standard deviations below the mean in healthy controls. We adjusted time‐to‐event analyses for age, body mass index, Charlson Comorbidity Index, forced expiratory volume in 1 second in % predicted, induction therapy, sex, smoking status, tumor stage, side of pneumonectomy, and institution. Results Three hundred and sixty‐seven patients (67.4% male, median age 62 years, 16.9% early‐stage) underwent predominantly standard pneumonectomy (89.6%) for stage IIIA NSCLC (45.5%) and squamous cell histology (58%). Sarcopenia was present in 104 of 367 patients (28.3%). Ninety‐day all‐cause mortality was 7.1% (26/367). After a median follow‐up of 20.5 months (IQR, 9.2–46.9), 183 of 367 patients (49.9%) had died. One hundred and thirty‐three (72.7%) of these deaths were due to lung cancer. Sarcopenia was associated with shorter CSS (HR 1.7, p = 0.008) and OS (HR 1.7, p = 0.003). Conclusions This transatlantic multicenter study confirms that sarcopenia on preoperative chest CT is an independent risk factor for CSS and OS following pneumonectomy for NSCLC.

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Does Assessment of Frailty and Sarcopenia in Lung Resection Candidates Affect Patient Selection?

Huisingh-Scheetz

Martinchek

2020

Difficult Decisions in Surgery: An Evidence-Based Approach

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Preoperative thoracic muscle area on computed tomography predicts long-term survival following pneumonectomy for lung cancer

Cited by 21 publications

References 29 publications

Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study

Feasibility, Safety and Effects of a One-Week, Ski-Based Exercise Intervention in Brain Tumor Patients and Their Relatives: A Pilot Study

Sarcopenia on preoperative chest computed tomography predicts cancer‐specific and all‐cause mortality following pneumonectomy for lung cancer: A multicenter analysis

Does Assessment of Frailty and Sarcopenia in Lung Resection Candidates Affect Patient Selection?

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