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Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer

BACKGROUND: Sarcopenia characterized by skeletal muscle loss may influence postoperative outcomes through physical decline and weakened immunity. We aimed to investigate clinical significance of sarcopenia in resected early-stage non-small cell lung cancer (NSCLC). METHODS: We retrospectively review...

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Autores principales: Takahashi, Yusuke, Suzuki, Shigeki, Hamada, Kenichi, Nakada, Takeo, Oya, Yuko, Sakakura, Noriaki, Matsushita, Hirokazu, Kuroda, Hiroaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944314/
https://www.ncbi.nlm.nih.gov/pubmed/33708952
http://dx.doi.org/10.21037/atm-20-4380
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author Takahashi, Yusuke
Suzuki, Shigeki
Hamada, Kenichi
Nakada, Takeo
Oya, Yuko
Sakakura, Noriaki
Matsushita, Hirokazu
Kuroda, Hiroaki
author_facet Takahashi, Yusuke
Suzuki, Shigeki
Hamada, Kenichi
Nakada, Takeo
Oya, Yuko
Sakakura, Noriaki
Matsushita, Hirokazu
Kuroda, Hiroaki
author_sort Takahashi, Yusuke
collection PubMed
description BACKGROUND: Sarcopenia characterized by skeletal muscle loss may influence postoperative outcomes through physical decline and weakened immunity. We aimed to investigate clinical significance of sarcopenia in resected early-stage non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed 315 consecutive patients with pathologic stage I NSCLC who had undergone lobectomy with systematic nodal dissection. Sarcopenia was defined as the lowest quartile of psoas muscle area on the 3rd vertebra on the high-resolution computed tomography (HRCT) image. Clinicopathological variables were used to investigate the correlation to postoperative complications as well as overall and recurrence-free survival. RESULTS: Upon multivariable analysis, male sex [odds ratio (OR) =5.780, 95% confidence interval (CI): 2.681–12.500, P<0.001], and sarcopenia (OR =21.00, 95% CI: 10.30–42.80, P<0.001) were independently associated with postoperative complications. The sarcopenia group showed significantly lower 5-over all survival (84.4% vs. 69.1%, P<0.001) and recurrence-free survival (77.2% vs. 62.0%, P<0.001) comparing with the non-sarcopenia group. In a multivariable analysis, sarcopenia was an independent prognostic factor [hazard ratio (HR) =1.978, 95% CI: 1.177–3.326, P=0.010] together with age ≥70 years (HR =1.956, 95% CI: 1.141–3.351, P=0.015) and non-adenocarcinoma histology (HR =1.958, 95% CI: 1.159–3.301, P=0.016). CONCLUSIONS: This is the first study which demonstrates that preoperative sarcopenia is significantly associated with unfavorable postoperative complications as well as long-term survival in pathologic stage I NSCLC. This readily available factor on HRCT may provide valuable information to consider possible choice of surgical procedure and perioperative management.
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spelling pubmed-79443142021-03-10 Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer Takahashi, Yusuke Suzuki, Shigeki Hamada, Kenichi Nakada, Takeo Oya, Yuko Sakakura, Noriaki Matsushita, Hirokazu Kuroda, Hiroaki Ann Transl Med Original Article BACKGROUND: Sarcopenia characterized by skeletal muscle loss may influence postoperative outcomes through physical decline and weakened immunity. We aimed to investigate clinical significance of sarcopenia in resected early-stage non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed 315 consecutive patients with pathologic stage I NSCLC who had undergone lobectomy with systematic nodal dissection. Sarcopenia was defined as the lowest quartile of psoas muscle area on the 3rd vertebra on the high-resolution computed tomography (HRCT) image. Clinicopathological variables were used to investigate the correlation to postoperative complications as well as overall and recurrence-free survival. RESULTS: Upon multivariable analysis, male sex [odds ratio (OR) =5.780, 95% confidence interval (CI): 2.681–12.500, P<0.001], and sarcopenia (OR =21.00, 95% CI: 10.30–42.80, P<0.001) were independently associated with postoperative complications. The sarcopenia group showed significantly lower 5-over all survival (84.4% vs. 69.1%, P<0.001) and recurrence-free survival (77.2% vs. 62.0%, P<0.001) comparing with the non-sarcopenia group. In a multivariable analysis, sarcopenia was an independent prognostic factor [hazard ratio (HR) =1.978, 95% CI: 1.177–3.326, P=0.010] together with age ≥70 years (HR =1.956, 95% CI: 1.141–3.351, P=0.015) and non-adenocarcinoma histology (HR =1.958, 95% CI: 1.159–3.301, P=0.016). CONCLUSIONS: This is the first study which demonstrates that preoperative sarcopenia is significantly associated with unfavorable postoperative complications as well as long-term survival in pathologic stage I NSCLC. This readily available factor on HRCT may provide valuable information to consider possible choice of surgical procedure and perioperative management. AME Publishing Company 2021-02 /pmc/articles/PMC7944314/ /pubmed/33708952 http://dx.doi.org/10.21037/atm-20-4380 Text en 2021 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Takahashi, Yusuke
Suzuki, Shigeki
Hamada, Kenichi
Nakada, Takeo
Oya, Yuko
Sakakura, Noriaki
Matsushita, Hirokazu
Kuroda, Hiroaki
Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title_full Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title_fullStr Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title_full_unstemmed Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title_short Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer
title_sort sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage i non-small cell lung cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944314/
https://www.ncbi.nlm.nih.gov/pubmed/33708952
http://dx.doi.org/10.21037/atm-20-4380
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