Sarcopenia is a novel poor prognostic factor in male patients with pathological Stage I non-small cell lung cancer.
OBJECTIVE
Sarcopenia is the progressive loss of muscle mass and strength, and has a risk of adverse outcomes such as disability, poor quality of life and death. As prognosis depends not only on disease aggressiveness, but also on a patient's physical condition, sarcopenia can predict survival in patients with various cancer types. However, its effects on postoperative prognosis in patients with localized non-small cell lung cancers (NSCLC) have never been reported.


METHODS
We retrospectively investigated 215 male patients with pathological Stage I NSCLC. L3 muscle index is defined as the cross-section area of muscle at the third lumbar vertebra level, normalized for height, and is a clinical measurement of sarcopenia. We then investigated the effect of preoperative sarcopenia on their postoperative prognosis.


RESULTS
Our 215 subjects included 30 patients with sarcopenia. Sarcopenia was significantly associated with body mass index, nutritional condition, serum CYFRA 21-1 level and pathological stage, but not with preoperative respiratory function or performance status. Frequency of postoperative complications, length of postoperative hospital stay, thoracic drainage period or causes of death were not correlated with the presence of sarcopenia. The sarcopenia group had a significantly shorter median overall survival (32 months) than the no-sarcopenia group.


CONCLUSIONS
Sarcopenia might not affect short-term outcomes in patients with early-stage lung cancer. Sarcopenia was a predictor of poor prognosis in male patients with Stage I NSCLC. As sarcopenic patients with NSCLC patients are at risk for significantly worse outcomes, their treatments require careful planning, even for those with Stage I disease.
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Takuma
T
Tsukioka
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Noritoshi
N
Nishiyama
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Nobuhiro
N
Izumi
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Shinjiro
S
Mizuguchi
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Hiroaki
H
Komatsu
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Satoshi
S
Okada
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Michihito
M
Toda
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Kantaro
K
Hara
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Ryuichi
R
Ito
Department of General Thoracic Surgery, Osaka City University Hospital,Osaka, Japan.
Toshihiko
T
Shibata
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications*
lung surgery; non-small cell lung cancer; sarcopenia