Visceral Obesity in Non-Small Cell Lung Cancer

Abstract

While obesity measured by body mass index (BMI) has been paradoxically associated with reduced risk and better outcome for lung cancer, recent studies suggest that the harm of obesity becomes apparent when measured as visceral adiposity. However, the prevalence of visceral obesity and its associations with demographic and tumor features are not established. We therefore conducted an observational study of visceral obesity in 994 non-small cell lung cancer (NSCLC) patients treated during 2008–2020 at our institution. Routine computerized tomography (CT) images of the patients, obtained within a year of tumor resection or biopsy, were used to measure cross-sectional abdominal fat areas. Important aspects of the measurement approach such as inter-observer variability and time stability were examined. Visceral obesity was semi-quantified as visceral fat index (VFI), the fraction of fat area that was visceral. VFI was found to be higher in males compared to females, and in former compared to current or never smokers. There was no association of VFI with tumor histology or stage. A gene expression-based measure of tumor immunogenicity was negatively associated with VFI but had no bearing with BMI. Visceral obesity is appraisable in routine CT and can be an important correlate in lung cancer studies.

Predicting the risk of lung cancer using machine learning: A large study based on UK Biobank

“…In past studies, BMI was often used to predict lung cancer. Olson [30] and Nitsche [31] et al pointed out that abdominal obesity had a more significant effect on the development of LC than overall obesity, and that BMI assessed comprehensive body mass index and waist circumference was used to evaluate abdominal obesity, and to recognize further the link between obesity and LC, waist circumference was included as a predictive variable in the present study. Stereotypes suggest that LC patients have insomnia, anxiety, depression, and other adverse psychological effects due to fear of the disease while ignoring whether emotions may also have an impact on lung cancer.…”

Influence of abdominal fat distribution and inflammatory status on post-operative prognosis in non-small cell lung cancer patients: a retrospective cohort study

“…1 ). A threshold range of − 190 to − 30 Hounsfield units (HU) was used to identify fat tissue (Nitsche et al 2022 ), while a range of − 29 to + 150 HU was used to identify muscle tissue, including the psoas, erector spinae, quadratus lumborum, transversus abdominis, internal and external oblique muscles, and rectus abdominis (Gomez-Perez et al 2016 ). Manual contour correction was performed independently by a trained radiologist, and intra-organ fat (such as renal intra-organ fat) was excluded.…”