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Sarcopenia is related to poor prognosis in patients after trimodality therapy for locally advanced non-small cell lung cancer

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Abstract

Background

The association between sarcopenia and prognosis in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing trimodality therapy, consisting of preoperative concurrent chemoradiotherapy and surgery, has not been reported. Therefore, we aimed to investigate the association of sarcopenia and fat mass with prognosis after trimodality therapy.

Methods

To assess sarcopenia, the psoas muscle mass was measured. Using computed tomography data, including third lumbar vertebra level images, psoas muscle mass and visceral and subcutaneous fat mass were measured. Additionally, body mass indices, and visceral/subcutaneous fat ratio, obtained by dividing the visceral fat index by the subcutaneous fat index, were calculated. We investigated the relationship between these parameters and overall survival.

Results

Ninety-nine eligible patients were included. In the univariate analysis, age, clinical stage, tumor location, psoas muscle index, and visceral/subcutaneous fat ratio were significant prognostic factors for overall survival (P = 0.008, P = 0.04, P = 0.04, P = 0.02, and P = 0.02, respectively). In the multivariate analysis, age and psoas muscle index were significant prognostic factors for overall survival (P = 0.01 and P = 0.03, respectively). The 5-year overall survival rates for the high and low psoas muscle index groups were 79.6% [95% confidence interval (CI), 67.1–94.5%] and 66.2% (95% CI, 54.1–81.1%), respectively; whereas, the 10-year overall survival rates were 61.9% (95% CI, 42.0–91.4%) and 25.3% (95% CI, 8.6–74.2%), respectively.

Conclusion

Sarcopenia was related to poor overall survival in patients with locally advanced NSCLC undergoing trimodality therapy. Assessment of body composition prior to treatment may provide important information for formulating rational therapeutic strategies.

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Acknowledgements

We are grateful to Dr. Shimpei Tsudaka and Dr. Hiromasa Yamamoto (Department of Thoracic Surgery, Okayama University Hospital) and Soichi Sugiyama (Department of Radiology, Okayama University Hospital) for data collection. We extend our sincere appreciation to all the patients who participated in this study.

Funding

This research was funded by the Tsuyama Chuo Hospital. The sponsors of this research were not involved in the conduct of this study, including study design, data collection, data analysis, data interpretation, manuscript writing, or the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Kuniaki Katsui

  2. Department of Radiology, Iwakuni Clinical Center, 1-1-1 Atagomachi, Iwakuni,, Yamaguchi, 740-8510, Japan

    Takeshi Ogata

  3. Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Kenta Watanabe & Kotaro Yoshio

  4. Department of Radiological Technology, Graduate School of Health Sciences, Okayama, University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Masahiro Kuroda

  5. Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Masaomi Yamane & Shinichi Toyooka

  6. Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Takao Hiraki & Susumu Kanazawa

  7. Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Katsuyuki Kiura

Authors
  1. Kuniaki Katsui
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  2. Takeshi Ogata
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  7. Takao Hiraki
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  8. Katsuyuki Kiura
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  9. Shinichi Toyooka
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  10. Susumu Kanazawa
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Contributions

KK collected the data and drafted the manuscript; TO performed the statistical analysis; and KW collected the data. All authors participated in the design of the study and read and approved the final manuscript.

Corresponding author

Correspondence to Kuniaki Katsui.

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Conflict of interest

All authors have no conflict of interest with respect to this study.

Ethical approval

The institutional review board of Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Okayama, University Hospital approved this study (approval number: 1809-018). The need for written informed consent was waived due to the retrospective nature of the study. The choice to opt out was provided through notifications displayed on the hospital’s website and outpatient ward before starting this study.

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Katsui, K., Ogata, T., Watanabe, K. et al. Sarcopenia is related to poor prognosis in patients after trimodality therapy for locally advanced non-small cell lung cancer. Int J Clin Oncol 26, 1450–1460 (2021). https://doi.org/10.1007/s10147-021-01927-7

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