BACKGROUND Sarcopenia is among the most prevalent and serious cancer-related symptom, and is strongly correlated with a poor prognosis. Moreover, it reportedly predicts poor prognosis after surgery in patients with lung cancer. However, it is unclear whether sarcopenia directly affects post-operative recurrence. The purpose of this study was to evaluate whether sarcopenia can be a risk indicator for post-operative recurrence, and whether it suppresses anti-tumor immunity, in a cohort of patients with resected non-small cell lung cancer. METHODS This study retrospectively reviewed the data of 256 consecutive patients who underwent curative lobectomy and lymph node dissection for non-small cell lung cancer at our institution. The psoas muscle mass index was calculated as the total psoas muscle area at the third lumbar vertebral level/height2 (cm2/m2). Sarcopenia was defined by a psoas muscle mass index of under 5.03 cm2/m2 and 3.17 cm2/m2 in male and female patients, respectively. Post-operative prognosis and cumulative incidence of recurrence rates were calculated. RESULTS The 5-year overall survival and disease-free survival rates post-surgery were 59.5% and 38.6%, respectively, in patients with sarcopenia versus 81.1% and 72.1%, respectively, in patients without sarcopenia (p < 0.001). The 5-year cumulative incidence of recurrence rate in patients with sarcopenia was significantly higher than those without sarcopenia (49.9% versus 22.4%, respectively) in every pathological stage. Pathological stages II and III (hazard ratio, 3.36; p = 0.004), histological type (hazard ratio, 2.31; p = 0.025), and sarcopenia (hazard ratio, 2.52; p = 0.001) were independent risk factors for post-operative recurrence according to multivariate analysis. CONCLUSION Sarcopenia is a risk indicator for post-operative recurrence in patients with non-small cell lung cancer.

中文翻译：

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肌肉减少症会增加非小细胞肺癌患者术后复发的风险。

背景肌肉减少症是最普遍和最严重的癌症相关症状之一，并且与不良预后密切相关。此外，据报道，它可以预测肺癌患者手术后的不良预后。然而，目前尚不清楚肌肉减少症是否直接影响术后复发。本研究的目的是在一组已切除的非小细胞肺癌患者中评估肌肉减少症是否可以作为术后复发的风险指标，以及它是否会抑制抗肿瘤免疫。方法 本研究回顾性回顾了我们机构 256 例接受根治性肺叶切除术和淋巴结清扫术的非小细胞肺癌患者的数据。腰大肌质量指数计算为第三腰椎水平处的总腰大肌面积/高度2 (cm2/m2)。肌肉减少症的定义是男性和女性患者的腰大肌质量指数分别低于 5.03 cm2/m2 和 3.17 cm2/m2。计算术后预后和复发率累积发生率。结果 肌肉减少症患者的 5 年总生存率和术后无病生存率分别为 59.5% 和 38.6%，而没有肌肉减少症的患者分别为 81.1% 和 72.1%（p < 0.001）。在每个病理阶段，肌肉减少症患者的 5 年累积复发率显着高于无肌肉减少症患者（分别为 49.9% 和 22.4%）。病理阶段 II 和 III（风险比，3.36；p = 0.004），根据多变量分析，组织学类型（风险比，2.31；p = 0.025）和肌肉减少症（风险比，2.52；p = 0.001）是术后复发的独立危险因素。结论 肌肉减少症是非小细胞肺癌患者术后复发的风险指标。