Sarcopenia assessed by skeletal muscle mass volume is a prognostic factor for oncological outcomes of rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by surgery

Horie, Kazumasa; Matsuda, Takeru; Yamashita, Kimihiro; Hasegawa, Hiroshi; Utsumi, Masako; Urakawa, Naoki; Kanaji, Shingo; Oshikiri, Taro; Kakeji, Yoshihiro

doi:10.1016/j.ejso.2021.10.018

Cited by 14 publications

(21 citation statements)

References 36 publications

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“…Sarcopenia, which refers to the loss of skeletal muscle mass and physical function with physical disability, has been suggested as an independent predictor of postoperative complications and poor overall survival (OS) in patients with cancer, including those with lung cancer (Nakamura et Shinohara et al 2020). Measuring psoas area index (PAI) of the bilateral psoas muscle areas at the third lumbar vertebra (L3) level on computed tomography (CT) is widely used for sarcopenia evaluation (Hamaguchi et al 2016); however, a novel method of measuring bilateral psoas major muscle volume on three-dimensional (3D) workstations has also been reported (Lee et al 2020;Horie et al 2021). A previous study reported that a diagnosis of sarcopenia based on the psoas volume index (PVI) indicates a risk of respiratory complications in patients with NSCLC (Lee et al 2020).…”

Section: Introductionmentioning

confidence: 99%

“…A previous study reported that a diagnosis of sarcopenia based on the psoas volume index (PVI) indicates a risk of respiratory complications in patients with NSCLC (Lee et al 2020). Horie et al reported that sarcopenia assessed using bilateral psoas muscle volume is likely to be more accurate in predicting oncological outcomes than PAI in patients with rectal cancer who underwent neoadjuvant chemoradiotherapy (Horie et al 2021). However, to our knowledge, there has been no study using PVI to examine the prognostic signi cance of sarcopenia in patients with early-stage NSCLC.…”

Section: Introductionmentioning

confidence: 99%

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

Yamada

Shimada

Makino

et al. 2022

J Cancer Res Clin Oncol

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yamada

Shimada

Makino

et al. 2022

J Cancer Res Clin Oncol

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“…Sarcopenia negatively affects clinical and oncological outcomes [14][15][16][17][18][19]. However, most previous studies did not determine whether laparoscopic surgery could eliminate the adverse effect of sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

“…The skeletal muscle index on CT images at the third lumbar vertebra (L3) level can be is used to measure sarcopenia. Several studies have shown that sarcopenia adversely affects postoperative complications and survival rates in rectal cancer patients [14][15][16][17][18][19]. However, most of these studies did not determine whether laparoscopic surgery could reduce the negative effects of sarcopenia.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia does not affect treatment outcomes in patients with rectal cancer undergoing laparoscopic surgery

Song

Lee

et al. 2022

Preprint

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Purpose Previous studies have reported that sarcopenia negatively impacts rectal cancer treatment. However, most published studies have analyzed only patients undergoing open surgery, and the association between sarcopenia and clinical outcomes in patients with rectal cancer undergoing laparoscopic surgery remains unclear. This study aimed to evaluate the effect of sarcopenia on the clinical and oncological outcomes of laparoscopic rectal cancer surgery. Methods Three hundred and one patients undergoing laparoscopic rectal cancer surgery were enrolled between December 2009 and May 2016. Body composition was assessed using computed tomography by measuring the muscle and fat areas at the third lumbar (L3) vertebra. The L3 skeletal muscle area was used to calculate the skeletal muscle index and evaluate sarcopenia. Results Sarcopenia was identified in 72/301 (23.9%) patients. Patients with sarcopenia had decreased skeletal muscle area (P < 0.001). However, there were no significant differences in visceral fat, subcutaneous fat, and body mass index. The time to tolerable soft diet and length of hospital stay were shorter in sarcopenia patients. The time to first flatus, postoperative complications, and overall and disease-free survival rates were not significantly different between those with and without sarcopenia. High American Society of Anesthesiologist classification (≥ 3; P = 0.014) and abdominoperineal resection (P = 0.003) were identified as risk factors for postoperative complications. Conclusion Sarcopenia does not negatively affect the functional recovery, postoperative complications, or survival after laparoscopic rectal cancer surgery. Further studies are necessary to validate that laparoscopic surgery could eliminate the negative impact of sarcopenia in patients with rectal cancer.

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“…CT imaging of the cross-sectional areas at the third lumbar vertebra (L3) is considered to be a reference for the diagnosis of sarcopenia because there is a linear relationship between the skeletal muscle mass index at L3 (L3MI) and whole-body muscle mass ( 9 ). The prognostic value of L3MI in gastrointestinal tumors ( 10 ), head and neck tumors ( 11 ), breast cancers, and non-small cell lung cancer (NSCLC) has been well-demonstrated ( 12 , 13 ), with low L3MI typically predictive of poor prognosis. However, the value of L3MI in extensive-stage SLCL remains controversial, Korean researchers reported that L3MI was independent prognostic factors of shorter OS in SCLC patients ( 14 ), but study from Japanese did not find significant associations of sarcopenia defined by muscle quantity with Overall survival (OS) in extensive-stage SCLC patients ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia defined by skeletal muscle mass index at the third lumbar vertebra is a prognostic factor for extensive-stage small cell lung cancer patients: a retrospective study

Wang¹,

Long²,

Sima³

et al. 2022

J Thorac Dis

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Background: Small cell lung cancer (SCLC) is one of the most aggressive types of lung cancer and reliable indicators are needed for improved patient management. The evaluation of skeletal muscle index of the third lumbar vertebra (L3MI) based on computed tomography (CT) is used to estimate patient prognosis in multiple cancers. However, its function in extensive-stage SCLC remains controversial. Considering that the maintenance of muscle mass may affect the survival of cancer patients. Herein, a retrospective study was conducted to investigate whether sarcopenia defined by skeletal muscle mass index at the third lumbar vertebra is a prognostic factor in extensive-stage SCLC cancer patients.Methods: This retrospective analysis included extensive-stage SCLC patients diagnosed at the Sun Yat-sen University Cancer Center from January 2009 to March 2017 with platinum-based chemotherapy. Clinical data were collated for further examination, and CT or positron emission tomography (PET)/CT datasets were analyzed for body mass index (BMI) and L3MI. Follow-up data were collected by contacting patients or their families. Overall survival (OS) was defined as the interval between the date of treatment started and the date of death or censoring. The Kaplan-Meier product limit method and log-rank tests were used to assess differences in OS between the high L3MI and low L3MI groups. Cox regression analysis was used to identify independent factors of OS.Results: For the 139 extensive-stage SCLC patients, the median follow-up time was 26.1 months (range, 0.4 to 79.4 months). The median OS was 9.5 months. There were no differences in age, inflammatory factors, nor progression after first-line treatment between the high L3MI and low L3MI groups. Kaplan-Meier analysis showed that the OS of the high L3MI group was significantly longer than that of the low L3MI group (14.045 vs. 9.985 months; P=0.007), and multivariate analysis identified high L3MI to be an independent prognostic factor for predicting longer OS in extensive-stage SCLC patients [hazard ratio (HR), 0.623; 95% confidence interval (CI), 0.405-0.960; P=0.032].Conclusions: Sarcopenia defined by L3MI is a prognostic factor for extensive-stage SCLC patients and early intervention of muscle mass maintaining may achieve better cancer management.

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Sarcopenia assessed by skeletal muscle mass volume is a prognostic factor for oncological outcomes of rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by surgery

Cited by 14 publications

References 36 publications

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

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

Sarcopenia does not affect treatment outcomes in patients with rectal cancer undergoing laparoscopic surgery

Sarcopenia defined by skeletal muscle mass index at the third lumbar vertebra is a prognostic factor for extensive-stage small cell lung cancer patients: a retrospective study

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