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Supportive Care in Cancer

, Volume 24, Issue 5, pp 2075–2084 | Cite as

Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer

  • Se-Il Go
  • Mi Jung Park
  • Haa-Na Song
  • Myoung Hee Kang
  • Hee Jung Park
  • Kyung Nyeo Jeon
  • Seok-Hyun Kim
  • Moon Jin Kim
  • Jung-Hun Kang
  • Gyeong-Won LeeEmail author
Original Article

Abstract

Purpose

Sarcopenia is suggested to be associated with cancer-related inflammation. We assessed the clinical outcome of small cell lung cancer (SCLC) patients according to sarcopenia and the neutrophil-to-lymphocyte ratio (NLR).

Methods

A total of 117 male SCLC patients treated with first-line chemo- or chemoradiotherapy were assessed based on a retrospective chart review. The mass of the pectoralis muscle was measured by computed tomography and normalized to height. Patients with the lowest quartile of muscle mass were considered to have sarcopenia. Patients were classified into four groups according to their sarcopenia and NLR statuses: sarcopenia/high NLR, sarcopenia/low NLR, non-sarcopenia/high NLR, and non-sarcopenia/low NLR.

Results

Sarcopenic patients had lower progression-free survival (PFS) than did non-sarcopenic patients (median 6.0 vs. 7.5 months, p = 0.009), but the difference in overall survival (OS) was not statistically significant (median 10.5 vs. 13.5 months, p = 0.052). However, the OS of sarcopenic patients with high NLR was significantly lower than that in all other groups (median 3.2 vs. 16.0 vs. 12.5 vs. 13.7 months, respectively, p < 0.001), as was PFS (median 3.2 vs. 7.7 vs. 7.6 vs. 7.1 months, respectively, p < 0.001). On multivariate analysis, sarcopenia with high NLR was an independent prognostic factor for shorter PFS and OS. Early discontinuation of treatment (20.0 vs. 10.3 %) and treatment-related mortality (50.0 vs. 8.4 %) occurred more frequently in these patients than in the other groups (p < 0.001).

Conclusions

In SCLC, sarcopenic male patients with high NLR have a poor prognosis and do not tolerate standard treatment. Intensive supportive care is needed in these patients.

Keywords

Sarcopenia Cachexia Neutrophil-to-lymphocyte ratio Small cell lung carcinoma Toxicity Prognosis 

Notes

Acknowledgments

No funding was received for the present study.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments.

Informed consent

This study is a retrospective analysis without any intervention and thus did not require informed consent.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Se-Il Go
    • 1
  • Mi Jung Park
    • 2
  • Haa-Na Song
    • 1
  • Myoung Hee Kang
    • 1
  • Hee Jung Park
    • 3
  • Kyung Nyeo Jeon
    • 2
  • Seok-Hyun Kim
    • 3
  • Moon Jin Kim
    • 4
  • Jung-Hun Kang
    • 5
  • Gyeong-Won Lee
    • 5
    Email author
  1. 1.Division of Hematology-Oncology, Department of Internal MedicineGyeongsang National University Hospital, Gyeongsang National University School of MedicineJinjuRepublic of Korea
  2. 2.Department of RadiologyGyeongsang National University Hospital, Gyeongsang National University School of MedicineJinjuRepublic of Korea
  3. 3.Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon HospitalSungkyunkwan University School of MedicineChangwonRepublic of Korea
  4. 4.Myongji HospitalGoyangRepublic of Korea
  5. 5.Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang Institute of Health ScienceGyeongsang National University Hospital, Gyeongsang National University School of MedicineJinjuRepublic of Korea

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