Sarcopenia and Visceral Adiposity Are Not Independent Prognostic Markers for Extensive Disease of Small-Cell Lung Cancer: A Single-Centered Retrospective Cohort Study

Abstract

Background Sarcopenia and visceral adiposity have been suggested to affect prognosis and treatment efficacy in various types of cancers. The aim of our study was to evaluate whether pretreatment sarcopenia and visceral adiposity are associated with prognosis in patients with extensive-disease small-cell lung cancer (ED-SCLC). Methods Between September 2007 and March 2018, 128 ED-SCLC patients received first-line and platinum-based chemotherapy at our hospital. Based on pretreatment body mass index (BMI), psoas muscle index (PMI), intramuscular adipose tissue content (IMAC) and visceral-to-subcutaneous fat ratio (VSR) at lumbar vertebra L3 level, we divided these patients into two groups, and then compared overall survival (OS) and progression-free survival (PFS). Adjusted by age, serum albumin, lactate dehydrogenase (LDH), clinical stage and performance status, we detected independent prognostic factors by multivariate Cox proportional hazard analyses. Results We did not find any significant differences in OS and PFS between two groups divided by BMI, PMI, IMAC and VSR. According to multivariate analyses, none of BMI, PMI, IMAC and VSR was an independent prognostic factor of OS and PFS. Conclusions Neither pretreatment sarcopenia nor visceral adiposity is a prognostic marker of patients with ED-SCLC treated with standard regimen of platinum-based chemotherapy.

Sarcopenia defined by skeletal muscle mass index at the third lumbar vertebra is a prognostic factor for extensive-stage small cell lung cancer patients: a retrospective study

“…Considering our study and previous reports ( 14 , 15 ), we hypothesize that sarcopenia defined by L3MI has prognostic value for SCLC patients, including those with extensive-stage SCLC. However, the clinical methods and standards of sarcopenia evaluation may vary among countries or occasions, leading to inconsistent results.…”

“…Furthermore, the latter study ( 17 ) showed that the presence of sarcopenia evaluated by L3MI at the time of diagnosis predicts poor outcomes (median OS of 5.0 months for patients with sarcopenia and adipopenia; 8.9 months for patients with sarcopenia; and 18.3 months for patients without sarcopenia or adipopenia). However, a Japanese study by Minami and colleagues found that sarcopenia evaluated by psoas muscle mass is not a prognostic marker for extensive-stage SCLC patients treated with a standard regimen of platinum-based chemotherapy ( 15 ).…”

“…The prognostic value of L3MI in gastrointestinal tumors ( 10 ), head and neck tumors ( 11 ), breast cancers, and non-small cell lung cancer (NSCLC) has been well-demonstrated ( 12 , 13 ), with low L3MI typically predictive of poor prognosis. However, the value of L3MI in extensive-stage SLCL remains controversial, Korean researchers reported that L3MI was independent prognostic factors of shorter OS in SCLC patients ( 14 ), but study from Japanese did not find significant associations of sarcopenia defined by muscle quantity with Overall survival (OS) in extensive-stage SCLC patients ( 15 ). The possible reason for this inconsistency seems to be that in Japanese study, researchers used a regional standard rather than international standard to identify sarcopenia.…”

Pretreatment glasgow prognostic score predicts survival among patients administered first-line atezolizumab plus carboplatin and etoposide for small cell lung cancer

“…This analysis failed to detect BMI as a prognostic factor for SCLC. In previous reports, BMI evaluation and treatment efficacy for SCLC varied with BMI cutoff points, clinical stage, treatment, and analytical methods (43,(47)(48)(49)(50)(51)(52)(53). Most studies did not show a significant association between the BMI and SCLC survival prognosis (43, 47-49, 51, 53).…”

Types of Cancer and Research Covered in World Journal of Oncology

“…In addition, we have noticed that there has been a huge increase in cancer immunology and immunotherapy interest. On immune checkpoint inhibition alone, Minami et al reported that sarcopenia and visceral adiposity did not affect its efficacy in lung cancer [ 31 ], Aly et al reported its use in sarcomatoid renal cell carcinoma [ 32 ], Tarekegn et al reported its use in relapsed/refractory classical Hodgkin lymphoma [ 33 ], Li et al reported its surrogate endpoints for gastro-esophageal carcinoma [ 34 ], and Rajapakse et al summarized one of its side effects [ 10 ]. Given the global pandemic of COVID-19 starting from 2020, our journal published three articles on this topic.…”