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

Suzuki, Yuzo; Okamoto, Tatsuro; Fujishita, Takatoshi; Katsura, Masakazu; Akamine, Takaki; Takamori, Shinkichi; Morodomi, Yosuke; Tagawa, Tetsuzo; Fukushima, Shoji; Maehara, Yoshihiko

doi:10.1016/j.lungcan.2016.08.007

Cited by 108 publications

(82 citation statements)

References 25 publications

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“…In hepatopancreatobiliary cancer, low SMM is associated with reduced OS . In patients with resectable early stage non‐small‐cell lung cancer, low SMM is associated with poor short‐term and long‐term outcomes after surgery . Low SMM has also been associated with prolonged hospital stay and increased health care‐related costs.…”

Section: Discussionsupporting

confidence: 91%

“…14 In patients with resectable early stage non-small-cell lung cancer, low SMM is associated with poor short-term and long-term outcomes after surgery. 27,28 Low SMM has also been associated with prolonged hospital stay and increased health care-related costs. A recent study in 452 patients undergoing abdominal surgery for cancer of the alimentary tract showed that patients with low SMM had a significantly longer hospital stay and significantly higher hospital costs than patients with normal SMM.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

et al. 2019

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Background Low skeletal muscle mass (SMM) is associated with postoperative complications, prolonged hospital stay, and short overall survival (OS) in surgical oncology. We aimed to investigate this association in patients undergoing total laryngectomy (TL). Methods A retrospective study was performed of patients undergoing TL. SMM was measured using CT or MRI scans at the level of the third cervical vertebra (C3). Results In all, 235 patients were included. Low SMM was observed in 109 patients (46.4%). Patients with low SMM had more pharyngocutaneous fistulas (PCFs) than patients with normal SMM (34.9% vs 20.6%; P = .02) and prolonged hospital stay (median, 17 vs 14 days; P < .001). In multivariate analysis, low SMM (hazards ratio, 1.849; 95% confidence interval, 1.202‐2.843) and high N stage were significant prognosticators of decreased OS. Conclusion Low SMM is associated with PCF and prolonged hospital stay in patients undergoing TL. Low SMM is an independent prognostic factor for shorter OS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

et al. 2019

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“…Hervochon et al demonstrated that BMI and total psoas area at the level of L3 were independent prognostic factors for patients undergoing pneumonectomy for NSCLC (29). Suzuki et al examined 90 consecutive patients undergoing lung resection for stage I NSCLC, and using L3MI to assess for sarcopenia, found that sarcopenia was an independent prognostic factor for survival as patient with a low muscle mass had a significant decrease in 5-year overall survival (20). Tsukioka et al reported on 215 male patients with pathological stage I NSCLC, and used a calculated L3MI derived from an equation using BSA to define sarcopenia; in their report, sarcopenia did not affect short-term outcomes, but was associated with a shorter median overall survival (21).…”

Section: Discussionmentioning

confidence: 99%

“…CT imaging has been found to correlate well with other methods of evaluating muscle mass, which is useful as CT imaging is routinely done prior to resection (19). In lung cancer, recent studies have found evidence that sarcopenia is an independent risk factor for decreased overall survival (20,21). In those studies, assessment of muscle mass was done at the level of L3, which sometimes necessitates a CT scan lower than routinely performed to evaluate chest pathology.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is a predictor of outcomes after lobectomy

et al. 2018

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Background: As screening for lung cancer rises, an increase in the diagnosis of early stage lung cancers is expected. Lobectomy remains the standard treatment, but there are alternatives, consideration of which requires an estimation of the risk of surgery. Sarcopenia, irrespective of body mass index, confers a worse prognosis in many groups of patients including those undergoing surgery. Here we examine the association of muscle mass with outcomes for patients undergoing lobectomy. Methods: Consecutive patients undergoing lobectomy were retrospectively reviewed. Preoperative computed tomography scans were reviewed, and cross-sectional area of the erector spinae muscles and pectoralis muscles was determined and normalized for height. Univariate and multivariate analyses were then done to examine for an association of muscle mass with morbidity and short-and long-term mortality. Results: During the study period, there were 299 lobectomies, 278 of which were done by video assisted thoracoscopic surgery. The average age of the patients was 67.5±10.6 years. Overall complication rate was 52.2%, pneumonia rate was 8.7%, and the 30-day mortality rate was 1.3%. Mean height adjusted-erector spinae muscle cross-sectional area was 10.6±2.6 cm 2 /m 2 , and mean height adjusted-pectoralis muscle cross sectional area was 13.3±3.8 cm 2 /m 2 . The height adjusted cross sectional areas of the erector spinae and pectoralis muscles were not associated with overall complication rate, rate of pneumonia, readmission, or intensive care unit length of stay. The height adjusted-erector spinae muscle cross sectional area was inversely correlated with 30-day mortality risk, odds ratio 0.77 (95% CI, 0.60-0.98, P=0.036). Mean length of stay was 7.0 days (95% CI, 5.5-8.4 days). Multivariate analysis demonstrated a significant inverse association of the height adjusted-erector spinae muscle cross sectional area with length of stay (P=0.019). Conclusions:The height adjusted-erector spinae muscle cross sectional area was significantly associated with 30-day mortality and length of stay in the hospital. Measurement of muscle mass on preoperative computed tomography imaging may have a role to help predict risk of morbidity and mortality prior to lobectomy.

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“…LC can be associated with secondary sarcopenia because of protein metabolic disorder and/or energy metabolic disorder [11,14,15]. Skeletal muscle mass loss can be linked to poorer clinical outcomes in LC patients, hepatocellular carcinoma (HCC) patients, or patients with other malignancies [17,18,19,20,21,22,23,24,25,26]. Skeletal muscle mass can be assessed by computed tomography (CT), magnetic resonance imaging (MRI), dual energy X-ray absorptiometry and bioimpedance analysis (BIA), which are consistent and accurate assessment modalities [14,15,17,19,27,28].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis

et al. 2017

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Aims: To investigate the influence of skeletal muscle mass index (SMI) as determined by bioimpedance analysis (BIA) (appendicular skeletal muscle mass/(height)2) on survival by comparing the Child-Pugh score in patients with liver cirrhosis (LC, n = 383, average age = 65.2 years). Patients and methods: In terms of comparison of the effects of SMI and other markers on survival, we used time-dependent receiver operating characteristics (ROC) analysis. Results: The average SMI for male was 7.4 cm2/m2 whereas that for female was 6.0 cm2/m2 (p < 0.0001). As for the Child-Pugh score, five points were in the majority, both in males (51.7%, (106/205)) and females (44.9%, (80/178)). For both genders, the survival curve was well stratified according to SMI (p < 0.0001 for males and p = 0.0056 for females). In the multivariate analysis for survival, SMI and Child-Pugh scores were found to be significant both in males and females. In time-dependent ROC analyses, all area under the ROCs (AUROCs) for SMI in each time point were higher than those for Child-Pugh scores in males, while in females AUROCs for Child-Pugh scores at each time point were higher than those for SMI. Conclusion: SMI using BIA can be helpful for predicting outcomes, at least in male LC patients.

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

Cited by 108 publications

References 25 publications

Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

Preoperative low skeletal muscle mass as a risk factor for pharyngocutaneous fistula and decreased overall survival in patients undergoing total laryngectomy

Sarcopenia is a predictor of outcomes after lobectomy

Comparison of Prognostic Impact between the Child-Pugh Score and Skeletal Muscle Mass for Patients with Liver Cirrhosis

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