Sarcopenia predicts poor postoperative outcome in elderly patients with lung cancer

Kawaguchi, Yo; Hanaoka, Jun; Ohshio, Yasuhiko; Okamoto, Keigo; Kaku, Ryosuke; Hayashi, Kazuki; Shiratori, Takuya; Yoden, Makoto

doi:10.1007/s11748-019-01125-3

Cited by 56 publications

(56 citation statements)

References 16 publications

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“…However, some of those papers were later excluded because there was no information on survival. Finally, a total of ten retrospective studies on long-term outcomes (7)(8)(9)(10)(11)(12)(13)(14)(15)(16), and six studies on short-term outcomes (8)(9)(10)(11)13,14) were included.…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Kawaguchi¹,

Hanaoka²,

Ohshio³

et al. 2021

J Thorac Dis

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Background: Lung cancer patients frequently suffer from sarcopenia, and reports on the association of resectable lung cancer and their postoperative outcomes are increasing. Information on whether sarcopenia has any impact on short-and long-term postoperative outcomes in patients surgically treated for nonsmall cell lung cancer remains insufficient. Furthermore, reports vary regarding the pathological stage, surgical procedure, diagnostic tool of sarcopenia, cut-off value, prognosis, and postoperative complications.We believe that sarcopenia assessment should be included as one of the factors which affect the surgical outcomes of lung cancer. Thus, we conducted a review and meta-analysis to ascertain the association between sarcopenia and postoperative outcomes. Methods: We performed a systematic literature search in PubMed/MEDLINE. Studies included cases defined sarcopenia, received lung cancer surgery, assessed postoperative complications, and prognosis. The pooled odds ratios for survival and postoperative complications, with 95% confidence intervals, were generated using Review manager 5.3. Results: A total of ten retrospective studies were eligible for this meta-analysis, including a total of 2,643 non-small cell lung cancer patients. All reviews used skeletal muscle mass as a diagnostic tool for sarcopenia.Sarcopenia was associated with worse survival outcomes and increased postoperative complications in patients with resected lung cancer. Conclusions: Sarcopenia is an independent risk factor for postoperative death and postoperative complications in patients who have undergone surgery. It is necessary to explore the mechanism of sarcopenia and optimal intervention, such as exercise, nutrition, or drug therapy.

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Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Kawaguchi¹,

Hanaoka²,

Ohshio³

et al. 2021

J Thorac Dis

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“…Sarcopenia gradually progress with age; hence, it is necessary to assess sarcopenia to predict outcomes in elderly patients with pulmonary disorders including pulmonary embolism [16][17][18]. The current definition of sarcopenia is based on quantitative (muscular mass) and functional (muscular strength and function) criteria.…”

Section: Discussionmentioning

confidence: 99%

Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In‐Hospital Mortality in Patients with Pulmonary Embolism

Akkoç

Toptaş

Yalcin

et al. 2020

BioMed Research International

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Aim. Sarcopenia, a core component of physical frailty, is an independent risk factor for suboptimal health outcomes in hospitalized patients, especially in the intensive care patients. Psoas muscle areas can be assessed to identify sarcopenia. The aim of this study was to determine the prognostic value of psoas muscle area measured with CT for the prediction of in-hospital mortality in patients with pulmonary embolism at admission to the intensive care unit. Methods. Patients with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay were reviewed. Selected clinical data of patients admitted to intensive care unit for the management of pulmonary embolism were collected. Using CT scan images at the level of L3 vertebra, the psoas muscle area value was obtained by dividing the sum of the right and left psoas muscle areas into the body surface area. Results. In-hospital mortality rate was 22.5% in 89 patients. The pulmonary embolism patients with in-hospital mortality had higher PESI and lower value of psoas muscle area, in addition to the lower systolic blood pressure and arterial oxygen saturation at admission. The increase in the value of psoas muscle area is associated with a decrease in the rate of in-hospital mortality. In patients with in-hospital mortality related to pulmonary embolism, the higher PESI and the lower value of psoas muscle area were considered in accordance with the outcome of patients. Conclusions. For the prediction of in-hospital mortality risk in patients with pulmonary embolism managed in intensive care unit, the psoas muscle area value has a merit to be used among the routine diagnostic procedures after further studies conducted with different severity of pulmonary embolism.

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“…Previous studies have reported conflicting findings on the association between preoperative muscle mass and complications after surgery in NSCLC patients (8,9,(11)(12)(13)(14)(15)(16)(17), and there may be several reasons for this discrepancy. First, a variety of methods have been used to measure the quantity of muscle across studies.…”

Section: Discussionmentioning

confidence: 99%

“…First, a variety of methods have been used to measure the quantity of muscle across studies. For example, it was suggested that the psoas muscle area, which has been used in some studies (9,12,14,15), is not representative of total skeletal muscle area (18,19). Additionally, although body muscle composition is highly influenced by sex, Miller et al did not perform a sex-specific analysis in their study (11).…”

Section: Discussionmentioning

confidence: 99%

Preoperative pectoralis muscle radiodensity as a risk factor for postoperative complications after thoracoscopic lobectomy for non-small cell lung cancer

Zhang

Chen

et al. 2021

Ann Palliat Med

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Background: Skeletal muscle radiodensity is associated with postoperative complications in cancer.However, data on skeletal muscle radiodensity and postoperative complication risk in patients with nonsmall cell lung cancer (NSCLC) are scarce, and this study investigated the relationship between skeletal muscle radiodensity and postoperative complication risk in patients with NSCLC treated by thoracoscopic lobectomy.Methods: Quantitative and qualitative measurements of the pectoralis muscle were performed on a single axial slice above the aortic arch in the precontrast computed tomography (CT) scan performed before surgery. Sex-specific cutoffs for the pectoralis muscle mass index (PMI) and pectoralis muscle radiodensity (PMD) were set at the lowest tertile. A Clavien-Dindo grade ≥ III within 30 days of the operation was considered as a major complication, and logistic regression analysis was performed to identify risk factors for postoperative complications.Results: The records of 163 consecutive patients with NSCLC receiving first-line thoracoscopic lobectomy between March 2016 and October 2019 were retrospectively reviewed and the PMI was found to be positively correlated with PMD (P<0.001). The PMI and PMD were significantly higher in men than in women (both P<0.001), and 23 (14.1%) patients experienced major postoperative complications. The multivariate analysis showed that male sex (P=0.032), lower body mass index (BMI) (P=0.016), and low PMD (P=0.012) before surgery, but not low PMI, were independent risk factors for major postoperative complications.Conclusions: Skeletal muscle quality but not muscle mass predicts major complications after thoracoscopic lobectomy for NSCLC. Skeletal muscle measures from the preoperative CT scan may be used to stratify patients with NSCLC into risk categories that can guide clinical decision-making.

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Sarcopenia predicts poor postoperative outcome in elderly patients with lung cancer

Cited by 56 publications

References 16 publications

Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Does sarcopenia affect postoperative short- and long-term outcomes in patients with lung cancer?—a systematic review and meta-analysis

Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In‐Hospital Mortality in Patients with Pulmonary Embolism

Preoperative pectoralis muscle radiodensity as a risk factor for postoperative complications after thoracoscopic lobectomy for non-small cell lung cancer

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