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The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Pericardial fat (PF) has not been considered a prognostic biomarker for overall survival (OS) in lung cancer. This study was designed to elucidate the impact of PF on prognosis of resected non-small cell lung cancer patients.

Methods

We retrospectively reviewed a total of 349 patients who underwent lung resection and received high-resolution computed tomography in our institute. PF volume was calculated. PF extended vertically from the diaphragm to the bifurcation of the right main pulmonary artery. Propensity score matched analysis was used to compare OS between the high- and low-PF groups.

Results

PF volume increased according to body mass index (p < 0.001). Receiver operating characteristics (ROC) curve analysis for 3-year OS showed the possibility of better predictivity of PF than body-mass index (area under the curve, 0.66 vs. 0.61, p = 0.010). Cutoff level of PF volume was determined based on the ROC with 122 cm3. Five-year OS was poorer in the low-PF group (63.5% vs. 73.4%; p = 0.002). After propensity score matching, each group consisted of 89 cases. Five-year OS was poorer in the low-PF group (66.5% vs. 82.7%; p = 0.008). A Cox proportional hazards model showed low-PF volume was associated with poorer OS (hazard ratio, 2.14; p = 0.009). The number of respiratory-related deaths was higher in the low-PF group (10/89 vs. 2/89, p = 0.032).

Conclusions

Low-PF volume may be associated with poor OS with an increase in the number of respiratory-related deaths. Patients with low-PF volume require careful follow-up after surgery.

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Acknowledgment

Aids for English language editing services in preparation of this manuscript were provided by Editage. In addition, Mitsutomo Arakawa, who is a radiological technician in our institution, made an enormous contribution to the calculation of PF and three-dimensional reconstruction of PF.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan

    Shuichi Shinohara MD, Kenichi Kobayashi MD, Masakazu Sugaya MD, PhD & Makoto Nakagawa MD, PhD

  2. Department of Pulmonary and Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Aichi, Japan

    Ryo Otsuki MD & Masaki Matsuo MD

  3. Department of Cardiology, Chubu Rosai Hospital, Nagoya, Aichi, Japan

    Ken Harada MD, PhD

Authors
  1. Shuichi Shinohara MD
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  2. Ryo Otsuki MD
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  3. Kenichi Kobayashi MD
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  4. Masaki Matsuo MD
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  5. Ken Harada MD, PhD
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  6. Masakazu Sugaya MD, PhD
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  7. Makoto Nakagawa MD, PhD
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Correspondence to Shuichi Shinohara MD.

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Shinohara, S., Otsuki, R., Kobayashi, K. et al. The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer. Ann Surg Oncol 27, 481–489 (2020). https://doi.org/10.1245/s10434-019-07703-2

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  • DOI: https://doi.org/10.1245/s10434-019-07703-2

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