Introduction: Skeletal muscle depletion, referred to as sarcopenia, has recently been identified as a risk factor for poor outcomes in various malignancies. However, the prognostic significance of sarcopenia in patients with NSCLC after surgery has not been adequately determined. This study investigated the impact of sarcopenia in patients undergoing pulmonary resection for lung cancer. Methods: This retrospective study consisted of 328 patients with pathologically confirmed NSCLC who underwent curative resection between January 2005 and April 2017. Preoperative computed tomography imaging at the third lumbar vertebrae level was assessed to measure the psoas muscle mass index (PMI, cm2/m2). Sarcopenia was defined as a cutoff value of PMI less than 6.36 cm2/m2 for males and 3.92 cm2/m2 for females, based on PMI values from “healthy” subjects. Results: The median patient age was 71 years and 59% were male. Sarcopenia was present in 183 (55.8%) and was significantly related with increasing age (p < 0.001), being male (p < 0.001), smoking habit (p < 0.001), lower body mass index (p < 0.001), and postoperative major complication (Clavien‐Dindo grade ≥3, p = 0.036). The prevalence of sarcopenia was higher in men than in women, and the prevalence increased with age in men, whereas the prevalence did not increase in females older than 70 years. The 5‐year survival rate was 61% in patients with sarcopenia and 91% in those without. Multivariate analysis revealed that sarcopenia was an independent unfavorable prognostic factor (p = 0.019). Conclusions: Sarcopenia as determined using preoperative computed tomography could be used to predict postoperative major complication and prognosis in patients with resected NSCLC. Our results may provide some important information for preoperative management.

中文翻译：

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切除的非小细胞肺癌中的肌肉减少症：对术后结果的影响

简介：骨骼肌耗竭，称为肌肉减少症，最近已被确定为各种恶性肿瘤预后不良的危险因素。然而，手术后 NSCLC 患者肌肉减少症的预后意义尚未得到充分确定。本研究调查了肌肉减少症对肺癌肺切除术患者的影响。方法：这项回顾性研究包括 2005 年 1 月至 2017 年 4 月期间接受根治性切除术的 328 名经病理证实的 NSCLC 患者。评估术前第三腰椎水平的计算机断层扫描成像以测量腰大肌质量指数（PMI，cm2/m2） . 根据“健康”受试者的 PMI 值，肌肉减少症被定义为男性和女性的 PMI 低于 6.36 cm2/m2 和 3.92 cm2/m2 的临界值。结果：患者的中位年龄为 71 岁，59% 为男性。183 人 (55.8%) 出现肌肉减少症，并且与年龄增长 (p < 0.001)、男性 (p < 0.001)、吸烟习惯 (p < 0.001)、体重指数降低 (p < 0.001) 和术后显着相关主要并发症（Clavien-Dindo 等级≥3，p = 0.036）。肌肉减少症的男性患病率高于女性，男性患病率随年龄增长而增加，而70岁以上女性的患病率没有增加。肌肉减少症患者的 5 年生存率为 61%，非肌肉减少症患者的 5 年生存率为 91%。多变量分析显示，肌肉减少症是一个独立的不利预后因素（p = 0.019）。结论：使用术前计算机断层扫描确定的肌肉减少症可用于预测切除的 NSCLC 患者的术后主要并发症和预后。我们的结果可能为术前管理提供一些重要信息。