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

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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.

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Acknowledgments

No funding was received for the present study.

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Author notes

    Authors and Affiliations

    1. Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea

      Se-Il Go, Haa-Na Song & Myoung Hee Kang

    2. Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea

      Mi Jung Park & Kyung Nyeo Jeon

    3. Division of Hematology and Medical Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea

      Hee Jung Park & Seok-Hyun Kim

    4. Myongji Hospital, Goyang, Republic of Korea

      Moon Jin Kim

    5. Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, 660-702, Republic of Korea

      Jung-Hun Kang & Gyeong-Won Lee

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    1. Se-Il Go
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    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.

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

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    Se-Il Go and Mi Jung Park contributed equally to this work.

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    Go, SI., Park, M.J., Song, HN. et al. Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer. Support Care Cancer 24, 2075–2084 (2016). https://doi.org/10.1007/s00520-015-2997-x

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