Abstract
Purpose
Sarcopenia influences postoperative outcomes of patients with non-small cell lung cancer (NSCLC). Imaging tools for evaluating and diagnosing sarcopenia have developed, and a novel method of psoas volume index (PVI) obtained by measuring bilateral psoas major muscle volume has been reported. However, the relationship between sarcopenia based on PVI and clinical outcomes has not been fully investigated for patients with early-stage NSCLC. This study aimed to clarify the utility of PVI values in assessing the relationshipe between sarcopenia and clinical outcomes.
Methods
This study included 645 patients with stage I-II NSCLC who underwent curative lung resection between 2012 and 2017. Bilateral psoas major muscle volumes were calculated semi-automatically using a three-dimensional workstation. The cutoff value of PVI for defining sarcopenia was < 60.5 cm3/m3 for men and < 43.6 cm3/m3 for women.
Results
The avrage time to obtaine PVI was only 25 s with the 3D system, and interobserver agreements for evauating sarcopenia on PVI was 1. A total of 159 patients (24.7%) were preoperatively diagnosed with sarcopenia. On multivariate analysis, sarcopenia was an independent prognostic factor for overall survival (OS, p < 0.001), recurrence-free survival (RFS, p < 0.001), and lung cancer-specific survival (LCS, p < 0.001). The 5-year OS, RFS, and LCS were significantly worse in sarcopenic patients than non-sarcopenic patients (88.8 vs. 72.4%, p < 0.001; 80.1 vs. 65.0%, p < 0.001; 92.4 vs. 78.9%, p < 0.001, respectively).
Conclusion
Sarcopenia diagnosed using PVI is an independent prognostic predictor of OS, RFS, and LCS in early-stage NSCLC.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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The authors thank Editage for English language editing and Mami Murakami for assistance with statistical analyses.
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All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by Yuki Yamada and Yoshihisa Shimada. The first draft of the manuscript was written by Yuki Yamada and all authors commented on previous versions of the manuscript. All authors read and approved final manuscript.
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432_2022_4234_MOESM1_ESM.tif
Supplementary file1. Distribution of the PVI (volume/ height cubed, cm3/m3) by sex. PVI, psoas volume index (TIF 721 KB)
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Yamada, Y., Shimada, Y., Makino, Y. et al. Clinical utility of psoas muscle volume in assessment of sarcopenia in patients with early-stage non-small cell lung cancer. J Cancer Res Clin Oncol 149, 3277–3285 (2023). https://doi.org/10.1007/s00432-022-04234-4
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DOI: https://doi.org/10.1007/s00432-022-04234-4