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The prognostic impact of sarcopenia on elderly patients undergoing pulmonary resection for non-small cell lung cancer

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Abstract

Purpose

The number of elderly patients who undergo surgery is increasing, even though they are at a high risk due to a decreased physical strength. Furthermore, sarcopenia is generally associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC).

Methods

This study included NSCLC patients  ≥ 65 years old who underwent pulmonary resection in our hospital between 2012 and 2015. Sarcopenia was assessed using the psoas muscle mass index based on computed tomography at the level of the third lumbar vertebra. We elucidated the impact of sarcopenia on short- and long-term outcomes after surgery.

Results

We enrolled 259 patients, including 179 with sarcopenia. Patients with sarcopenia before surgery tended to have postoperative complications (p = 0.0521), although they did not show a poor prognosis. In patients with sarcopenia, a multivariate analysis revealed that postoperative complications and the progression of sarcopenia 1 year after surgery were significant risk factors for a poor prognosis (p = 0.0169 and 0.00370, respectively).

Conclusions

The progression of sarcopenia after surgery is associated with a poor prognosis in elderly NSCLC patients with sarcopenia. A strategy to prevent postoperative progressive sarcopenia may be necessary for improving the clinical outcome of this population.

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Acknowledgements

We thank Drs. Naomichi Murata and Yukio Kobayashi, The Center for Special Needs Dentistry, Okayama University Hospital, for providing advice and encouragement. This work is supported by Management Expensive Grants in National University Corporations in Japan.

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Authors and Affiliations

  1. 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

    Akihiro Miura, Hiromasa Yamamoto, Hiroki Sato, Yasuaki Tomioka, Toshio Shiotani, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane & Shinichi Toyooka

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

    Hiromasa Yamamoto, Ken Suzawa, Kentaroh Miyoshi, Shinji Otani, Mikio Okazaki, Masaomi Yamane & Shinichi Toyooka

  3. Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Yasuaki Tomioka, Toshio Shiotani & Seiichiro Sugimoto

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  1. Akihiro Miura
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  2. Hiromasa Yamamoto
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Correspondence to Hiromasa Yamamoto.

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Miura, A., Yamamoto, H., Sato, H. et al. The prognostic impact of sarcopenia on elderly patients undergoing pulmonary resection for non-small cell lung cancer. Surg Today 51, 1203–1211 (2021). https://doi.org/10.1007/s00595-020-02221-1

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