Clinical utility of psoas muscle volume in assessment of sarcopenia in patients with early-stage non-small cell lung cancer

Abstract

Sarcopenia in uences postoperative outcomes of patients with non-small cell lung cancer (NSCLC). Psoas volume index (PVI) has been used to evaluate sarcopenia. However, the relationship between sarcopenia based on PVI and clinical outcomes has not been fully investigated for patients with earlystage NSCLC. This study aimed to clarify the clinical utility of PVI values in assessing sarcopenia. MethodsThis study included 645 patients with stage I-II NSCLC who underwent curative lung resection between 2012 and 2017. Bilateral psoas major muscle volumes were calculated semi-automatically using a threedimensional workstation. The cutoff value of PVI for de ning sarcopenia was < 60.5 cm 3 /m 3 for men and < 43.6 cm 3 /m 3 for women. Propensity score-matched analysis was performed to eliminate imbalances in baseline characteristics of patients according to the presence of sarcopenia. ResultsA total of 159 patients (24.7%) were diagnosed with sarcopenia preoperatively. On multivariate analysis, sarcopenia was an independent unfavorable prognostic factor associated with overall survival (OS) and recurrence-free survival (RFS) (both p < 0.001). There were 145 patients in both the sarcopenia and nonsarcopenia groups after propensity score matching; the 5-year OS and RFS were signi cantly worse in patients with sarcopenia than in those without (91.3% vs. 75.4%, p < 0.001 and 84.3% vs. 67.9%, p = 0.002). The 5-year lung cancer-speci c survival (LCS) was signi cantly worse in patients with sarcopenia than in those without (94.8% vs. 81.3%, p = 0.001). ConclusionSarcopenia diagnosed using PVI is an independent prognostic predictor of OS, RFS, and LCS in early stage NSCLC. This novel application of sarcopenia assessment is useful for predicting survival of patients with NSCLC.

Use of 3D-CT-Derived Psoas Major Muscle Volume in Defining Sarcopenia in Colorectal Cancer

“…However, there are methods involving height squared and cubed for this purpose, and as a result, cutoff values remain uncertain. It is possible that the cutoff used in this study was somewhat stringent [6, 22,23]. We also found a strong correlation between PVI and PAI (r = 0.66), as illustrated in Fig.…”

“…In CRC, there are reports on use of PV and PA for post-chemoradiotherapy rectal cancer and postoperative complications [22][23][24][25][26], but we could not nd any studies on long-term prognosis and 5-year survival rate in elderly patients with CRC. In this regard, our study is novel in addressing these perspectives.…”

“…In previous reports, Horie et al have suggested that evaluating PV may have higher reliability than PA since it involves measuring a broader range of the muscle, thereby reducing errors [22]. In PA measurement, the measured height may not correspond to the maximum area, and signi cant variations can occur depending on the level of measurement [23,24]. So et al argued that 3D assessments in patients with hip fractures are more accurate for evaluating muscle mass compared to 2D methods [25].…”

“…Among these, myostatin is associated with transforming growth factor-β, interleukin-15, NK cells, CD3, and CD8 T cells, all of which are linked to tumor progression. A decline in skeletal muscle mass can disrupt the balance of cytokines, potentially contributing to cancer progression and recurrence [23,[29][30][31]. For these reasons, the coexistence of sarcopenia in cancer has been associated with progression and a worsened prognosis, which includes a poorer survival curve.…”

Prediction of postoperative pulmonary complications in older patients undergoing lobectomy for lung cancer based on skeletal muscle mass

“…However, psoas muscle is originated from T12 and inserted to femur. Scanning from chest to lower limbs is required for the exact evaluation of psoas muscle and muscle mass at the mid-level of psoas muscle, taken from abdominal scanning, has been used in the previous studies ( 17 , 18 ). Additionally, scanning increased the risk for the exposure of biohazard.…”