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Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer
BACKGROUND: Sarcopenia is associated with poor prognosis in lung cancer. Skeletal muscle area can be quantified based on radiodensity of CT scan. The purpose of this study was to evaluate the prognostic significance of radiodensity-based detailed skeletal muscle quantification on outcomes after surg...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947473/ https://www.ncbi.nlm.nih.gov/pubmed/33717547 http://dx.doi.org/10.21037/jtd-20-2344 |
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author | Kim, Eun Young Kim, Young Jae Kim, Young Saing Kim, Kun Woo Jeon, Ji Young Kim, Kwang Gi |
author_facet | Kim, Eun Young Kim, Young Jae Kim, Young Saing Kim, Kun Woo Jeon, Ji Young Kim, Kwang Gi |
author_sort | Kim, Eun Young |
collection | PubMed |
description | BACKGROUND: Sarcopenia is associated with poor prognosis in lung cancer. Skeletal muscle area can be quantified based on radiodensity of CT scan. The purpose of this study was to evaluate the prognostic significance of radiodensity-based detailed skeletal muscle quantification on outcomes after surgery of non-small cell lung cancer (NSCLC). METHODS: Single cross-sectional area of the skeletal muscle (−29 to 150 HU) at the 3rd lumbar vertebra (L3) level retrospectively measured on preoperative CT for NSCLC patients (n=272), who underwent surgical resection during 2011 to 2016. The diagnosis of sarcopenia was made when a L3 muscle index (L3MI; L3 muscle area/height2) of less than 55 cm(2)/m(2) for men and less than 39 cm(2)/m(2) for women. Skeletal muscle was subsequently classified based on radiodensity level as low attenuation muscle (−29 to <30 HU) and high attenuation muscle (30 to 150 HU). Using a maximal-chi-squared test, low attenuation muscle accounted less than 24.5% of the total muscle, which was considered healthy muscle. Data on clinical characteristics (demographic information, TNM stage, histology) and prognosis (disease-free survival; DFS, and overall survival; OS) were collected. RESULTS: Sarcopenia was found 22.4% in preoperative CT (32.9% for men and 6.5% for women). The prevalence of patients with healthy muscle was 15.4% (21.3% for men and 6.5% for women). There was no significant difference between the 3-year DFS rate (77.0% vs. 67.0%, P=0.142) or 3-year OS rate (84.8% vs. 87.9%, P=0.576) between patients with and without sarcopenia. However, patients with healthy muscle tend to show longer 3-year DFS rate (79.4% vs. 67.2%, P=0.094) and 3-year OS rate (92.6% vs. 86.1%, P=0.176). In the multivariable analysis, healthy muscle was one of the independent prognosticators for a 3-year DFS rate (HR, 0.50, P=0.035), along with R1 resection (HR, 5.90, P<0.001), pathologic T stage (HR, 2.69, P<0.001), and pathologic N stage (HR, 2.43, P<0.001). CONCLUSIONS: The proportion of low attenuation muscle was associated with DFS in resected lung cancer patients. Further investigation is needed to establish whether radiodensity-based detailed skeletal muscle quantification could be early biomarker to predict prognosis in NSCLC. |
format | Online Article Text |
id | pubmed-7947473 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-79474732021-03-12 Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer Kim, Eun Young Kim, Young Jae Kim, Young Saing Kim, Kun Woo Jeon, Ji Young Kim, Kwang Gi J Thorac Dis Original Article BACKGROUND: Sarcopenia is associated with poor prognosis in lung cancer. Skeletal muscle area can be quantified based on radiodensity of CT scan. The purpose of this study was to evaluate the prognostic significance of radiodensity-based detailed skeletal muscle quantification on outcomes after surgery of non-small cell lung cancer (NSCLC). METHODS: Single cross-sectional area of the skeletal muscle (−29 to 150 HU) at the 3rd lumbar vertebra (L3) level retrospectively measured on preoperative CT for NSCLC patients (n=272), who underwent surgical resection during 2011 to 2016. The diagnosis of sarcopenia was made when a L3 muscle index (L3MI; L3 muscle area/height2) of less than 55 cm(2)/m(2) for men and less than 39 cm(2)/m(2) for women. Skeletal muscle was subsequently classified based on radiodensity level as low attenuation muscle (−29 to <30 HU) and high attenuation muscle (30 to 150 HU). Using a maximal-chi-squared test, low attenuation muscle accounted less than 24.5% of the total muscle, which was considered healthy muscle. Data on clinical characteristics (demographic information, TNM stage, histology) and prognosis (disease-free survival; DFS, and overall survival; OS) were collected. RESULTS: Sarcopenia was found 22.4% in preoperative CT (32.9% for men and 6.5% for women). The prevalence of patients with healthy muscle was 15.4% (21.3% for men and 6.5% for women). There was no significant difference between the 3-year DFS rate (77.0% vs. 67.0%, P=0.142) or 3-year OS rate (84.8% vs. 87.9%, P=0.576) between patients with and without sarcopenia. However, patients with healthy muscle tend to show longer 3-year DFS rate (79.4% vs. 67.2%, P=0.094) and 3-year OS rate (92.6% vs. 86.1%, P=0.176). In the multivariable analysis, healthy muscle was one of the independent prognosticators for a 3-year DFS rate (HR, 0.50, P=0.035), along with R1 resection (HR, 5.90, P<0.001), pathologic T stage (HR, 2.69, P<0.001), and pathologic N stage (HR, 2.43, P<0.001). CONCLUSIONS: The proportion of low attenuation muscle was associated with DFS in resected lung cancer patients. Further investigation is needed to establish whether radiodensity-based detailed skeletal muscle quantification could be early biomarker to predict prognosis in NSCLC. AME Publishing Company 2021-02 /pmc/articles/PMC7947473/ /pubmed/33717547 http://dx.doi.org/10.21037/jtd-20-2344 Text en 2021 Journal of Thoracic Disease. 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 Kim, Eun Young Kim, Young Jae Kim, Young Saing Kim, Kun Woo Jeon, Ji Young Kim, Kwang Gi Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title | Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title_full | Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title_fullStr | Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title_full_unstemmed | Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title_short | Prognostic significance of radiodensity-based skeletal muscle quantification using preoperative CT in resected non-small cell lung cancer |
title_sort | prognostic significance of radiodensity-based skeletal muscle quantification using preoperative ct in resected non-small cell lung cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947473/ https://www.ncbi.nlm.nih.gov/pubmed/33717547 http://dx.doi.org/10.21037/jtd-20-2344 |
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