Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer

Kimura, Masashi; Naito, Tateaki; Kenmotsu, Hirotsugu; Taira, Tetsuhiko; Wakuda, Kazushige; Oyakawa, Takuya; Hisamatsu, Yasushi; Tokito, Takaaki; Imai, Hisao; Akamatsu, Hiroaki; Ono, Akira; Kaira, Kyoichi; Murakami, Haruyasu; Endo, Masahiro; Mori, Keita; Takahashi, Toshiaki; Yamamoto, Nobuyuki

doi:10.1007/s00520-014-2534-3

Cited by 146 publications

(164 citation statements)

References 21 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…After chemotherapy, men had a significantly higher decrease in muscle tissue than women, which was also seen by Kimura et al [7]. Regarding age, all adipose tissue compartments increased significantly more in younger than in older patients.…”

Section: Discussionsupporting

confidence: 76%

Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients

et al. 2017

View full text Add to dashboard Cite

IntroductionCachexia and sarcopenia are associated with poor outcome and increased chemotherapy-induced toxicity in lung cancer patients. However, the complex interplay of obesity, sarcopenia and cachexia, and its impact on survival in the context of first-line-chemotherapy is not yet understood.MethodsIn 200 consecutively recruited lung cancer patients (70 female, mean age 62y; mean BMI 25 kg/m2; median follow-up 15.97 months) with routine staging-CT before and after chemotherapy (CTX, mean interval: 4.3 months), densitometric quantification of total (TFA), visceral (VFA), and subcutaneous-fat-area (SFA), inter-muscular-fat-area (IMFA), muscle-density (MD), muscle-area (MA) and skeletal-muscle-index (SMI) was performed retrospectively to evaluate changes under chemotherapy and the impact on survival.ResultsWe observed increases in TFA, VFA, SFA, VFA/SFA, and IMFA (p<0.05–0.001), while there were decreases in MA, MD and BMI (p<0.05–0.001) after chemotherapy. High pre-therapeutic VFA/SFA was a predictive factor for poor survival (HR = 1.272; p = 0.008), high pre-therapeutic MD for improved survival (HR = 0.93; p<0.05). Decrease in BMI (HR = 1.303; p<0.001), weight (HR = 1.067; p<0.001) and SMI (HR = 1.063; p<0.001) after chemotherapy were associated with poor survival. Patients with ≥4 CTX-cycles showed increased survival (17.6 vs. 9.1months), less muscle depletion (SMIdifference: p<0.05) and no BMI loss (BMIdifference: p<0.001).ConclusionsAfter chemotherapy, patients exhibited sarcopenia with decreased muscle and increased adipose tissue compartments, which was not adequately mirrored by BMI and weight loss but by imaging. Particularly sarcopenic patients received less CTX-cycles and had poorer survival. As loss of BMI, weight and muscle were associated with poor survival, early detection (via imaging) and prevention (via physical exercise and nutrition) of sarcopenia may potentially improve outcome and reduce chemotherapy-induced toxicity.

show abstract

Section: Discussionsupporting

confidence: 76%

Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Several studies have reported that skeletal muscle mass decreases in patients receiving chemotherapy [20,21,22]. Kimura et al [23] reported that cancer-related cachexia and decreased skeletal muscle mass are associated with a poor prognosis in patients undergoing chemotherapy. We were unable to investigate nutrition treatment and skeletal muscle mass.…”

Section: Discussionmentioning

confidence: 99%

Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer

Minami

Sozu

Niki³

et al. 2016

Chemotherapy

View full text Add to dashboard Cite

Background: We examined whether the weight loss that occurs with platinum-based chemotherapy in lung cancer patients is associated with chemotherapy side effects, treatment completion rates and therapeutic effect. Methods: We retrospectively reviewed charts of advanced lung cancer patients treated with ≥2 cycles of platinum-based chemotherapy. Patients were divided into 2 groups based on ≥5 or <5% weight loss. Relationships between weight loss and other variables were investigated. Results: Among 114 patients, 18 (15.8%) experienced ≥5% weight loss. Significantly more patients with small-cell lung cancer (SCLC) than with non-SCLC were found to have ≥5% weight loss (30.8 vs. 11.4%, p = 0.023). Patients with ≥5% weight loss experienced higher incidences of grade 3-4 leukopenia (p = 0.008) and neutropenia (p = 0.005), and treatment completion rates were lower in this group (p = 0.035). Weight loss was not significantly associated with therapeutic effect. Conclusion: The weight loss in patients with advanced lung cancer receiving platinum-based chemotherapy is associated with SCLC, grade 3-4 leukopenia, neutropenia and a decrease in treatment completion rate.

show abstract

“…(1-4) International consortia have thus identified early recognition of cancer cachexia as a critical goal, calling for interventions to be targeted early in the process rather than when end-stage wasting occurs. (5)…”

Section: Introductionmentioning

confidence: 99%

Lower Pectoralis Muscle Area Is Associated with a Worse Overall Survival in Non–Small Cell Lung Cancer

Kinsey

Estépar

Velden

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Background Muscle wasting is a component of the diagnosis of cancer cachexia and has been associated with poor prognosis. However, recommended tools to measure sarcopenia are limited by poor sensitivity or the need to perform additional scans. We hypothesized that pectoralis muscle area (PMA) measured objectively on chest CT scan may be associated with overall survival in non-small cell lung cancer (NSCLC). Methods We evaluated two hundred fifty two cases from a prospectively enrolling lung cancer cohort. Eligible cases had CT scans performed prior to the initiation of surgery, radiation, or chemotherapy. PMA was measured in a semi-automated fashion while blinded to characteristics of the tumor, lung, and patient outcomes. Results Men had a significantly greater PMA than women (37.59 vs 26.19 cm2, P<0.0001). In univariate analysis, PMA was associated with age and BMI. A Cox proportional hazards model was constructed to account for confounders associated with survival. Lower pectoralis area (per cm2) at diagnosis was associated with an increased hazard of death of 2% (HRadj 0.98 [0.96, 0.99], P=0.044) while adjusting for age, sex, smoking, chronic bronchitis, emphysema, histology, stage, chemotherapy, radiation, surgery, BMI, and ECOG performance status. . Conclusions Lower pectoralis muscle area measured from chest CT scans obtained at the time of diagnosis of NSCLC is associated with a worse overall survival. Impact Pectoralis muscle area may be a valuable CT biomarker for sarcopenia associated lung cancer survival.

show abstract

Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer

Abstract: CC presence and decreased skeletal muscle mass are associated with poor prognosis in advanced NSCLC patients receiving chemotherapy.

Cited by 146 publications

References 21 publications

Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients

Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients

Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer

Lower Pectoralis Muscle Area Is Associated with a Worse Overall Survival in Non–Small Cell Lung Cancer

Contact Info

Product

Resources

About