Muscle Quality Predicts Outcomes after Surgery for Early-Stage Non-Small-Cell Lung Cancer

Ann Thorac Cardiovasc Surg. 2022 Aug 20;28(4):262-270. doi: 10.5761/atcs.oa.21-00274. Epub 2022 Mar 16.

Abstract

Purpose: This study investigated the impact of skeletal muscle quality on the outcomes of patients undergoing surgery for early-stage non-small-cell lung cancer (NSCLC).

Methods: A total of 98 patients with pathological stage I-II NSCLC who underwent lobectomy or segmentectomy were retrospectively analyzed. Along with skeletal muscle quantity, muscle quality was evaluated by intramuscular adipose tissue content (IMAC) at the first lumbar vertebral level; a higher IMAC indicates lower skeletal muscle quality. Patients were divided into two groups according to the gender-specific quartiles of IMAC, and the prognostic impact of IMAC was investigated.

Results: No significant differences in the body and skeletal mass indices, which indicate skeletal muscle quantity, were observed between patients with high and those with normal IMAC. Patients with high IMAC (n = 23) showed a significantly poorer prognosis in overall and disease-specific survivals than those with normal IMAC (n = 75; P <0.001 and P = 0.048, respectively). In a bivariate analysis that included other clinicopathological factors, a high IMAC was independently associated with worse overall survival.

Conclusion: The skeletal muscle quality evaluated by IMAC could be used to predict survival risk after surgery for early-stage NSCLC.

Keywords: muscle quality; muscle quantity; non–small-cell lung cancer; sarcopenia.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Humans
  • Lung Neoplasms* / pathology
  • Muscle, Skeletal / pathology
  • Retrospective Studies
  • Sarcopenia* / diagnostic imaging
  • Sarcopenia* / etiology
  • Treatment Outcome