The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer

Shinohara, Shuichi; Otsuki, Ryo; Kobayashi, Kenichi; Matsuo, Masaki; Harada, Ken; Sugaya, Masakazu; Nakagawa, Makoto

doi:10.1245/s10434-019-07703-2

Cited by 8 publications

(4 citation statements)

References 29 publications

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“… 17 , 18 Pericardial fat extends vertically from the right pulmonary artery to the diaphragm and horizontally from the left edge of the apex to the right edge of the atrium, and the area of fat was identified by CT densities between −190 and −30 HU. Pericardial fat volume (cm 3 ) was automatically calculated once the pericardial fat was identified 16 ( Figure 2D–F ).…”

Section: Methodsmentioning

confidence: 99%

“…However, the relationship between OS and fat in NSCLC patients has been poorly reported. Previous studies have found that pericardial fat, a representative of visceral fat, is associated with NSCLC prognosis, 15 and low pericardial fat volume may be associated with poor OS 16 . To date, the effects of skeletal muscle and fat on the prognosis of NSCLC patients remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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Increased adipose tissue is associated with improved overall survival, independent of skeletal muscle mass in non‐small cell lung cancer

Tao,

Fang,

Chen

et al. 2023

J cachexia sarcopenia muscle

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BackgroundThe prognostic significance of non‐cancer‐related prognostic factors, such as body composition, has gained extensive attention in oncological research. Compared with sarcopenia, the prognostic significance of adipose tissue for overall survival in non‐small cell lung cancer remains unclear. We investigated the prognostic value of skeletal muscle and adipose tissue in patients with non‐small cell lung cancer.MethodsThis retrospective study included 4434 patients diagnosed with non‐small cell lung cancer between January 2014 and December 2016. Cross‐sectional areas of skeletal muscle and subcutaneous fat were measured, and the pericardial fat volume was automatically calculated. The skeletal muscle index and subcutaneous fat index were calculated as skeletal muscle area and subcutaneous fat area divided by height squared, respectively, and the pericardial fat index was calculated as pericardial fat volume divided by body surface area. The association between body composition and outcomes was evaluated using Cox proportional hazards model.ResultsA total of 750 patients (501 males [66.8%] and 249 females [33.2%]; mean age, 60.9 ± 9.8 years) were included. Sarcopenia (60.8% vs. 52.7%; P < 0.001), decreased subcutaneous fat index (51.4% vs. 25.2%; P < 0.001) and decreased pericardial fat index (55.4% vs. 16.5%; P < 0.001) were more commonly found in the deceased group than survived group. In multivariable Cox regression analysis, after adjusting for clinical variables, increased subcutaneous fat index (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.47–0.66, P < 0.001) and increased pericardial fat index (HR = 0.47, 95% CI: 0.40–0.56, P < 0.001) were associated with longer overall survival. For stage I–III patients, increased subcutaneous fat index (HR = 0.62, 95% CI: 0.48–0.76, P < 0.001) and increased pericardial fat index (HR = 0.43, 95% CI: 0.34–0.54, P < 0.001) were associated with better 5‐year overall survival rate. Similar results were recorded in stage IV patients. For patients with surgery, the prognostic value of increased subcutaneous fat index (HR = 0.60, 95% CI: 0.44–0.80, P = 0.001) and increased pericardial fat index (HR = 0.51, 95% CI: 0.38–0.68, P < 0.001) remained and predicted favourable overall survival. Non‐surgical patients showed similar results as surgical patients. No association was noted between sarcopenia and overall survival (P > 0.05).ConclusionsIncreased subcutaneous fat index and pericardial fat index were associated with a higher 5‐year overall survival rate, independent of sarcopenia, in non‐small cell lung cancer and may indicate a reduced risk of non‐cancer‐related death.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased adipose tissue is associated with improved overall survival, independent of skeletal muscle mass in non‐small cell lung cancer

Tao,

Fang,

Chen

et al. 2023

J cachexia sarcopenia muscle

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show abstract

“…Decreased muscle mass and FFM were also independently associated with increased risk of postoperative complications (prolonged air leak, pneumonia) and prolonged length of stay ( 102 , 114 ). When pericardial fat volume was used as a measure of obesity, higher fat volumes were associated with higher BMI and better RFS and OS in NSCLC patients undergoing resection ( 115 ). Using metabolic score as a measure of inflammation, Yuan et al found that a combination of BMI and metabolic score was predictive of readmission in NSCLC patients after surgery ( 116 ).…”

Section: Obesity and Therapeutic Survival Of Lung Cancermentioning

confidence: 99%

Obesity and lung cancer—a narrative review

Vedire¹,

Kalvapudi²,

Yendamuri³

2023

J Thorac Dis

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Background and Objective A highly nuanced relationship exists between obesity and lung cancer. The association between obesity and lung cancer risk/prognosis varies depending on age, gender, race, and the metric used to quantify adiposity. Increased body mass index (BMI) is counterintuitively associated with decreased lung cancer incidence and mortality, giving rise to the term ‘obesity paradox’. Potential explanations for this paradox are BMI being a poor measure of obesity, confounding by smoking and reverse causation. A literature search of this topic yields conflicting conclusions from various authors. We aim to clarify the relationship between various measures of obesity, lung cancer risk, and lung cancer prognosis. Methods The PubMed database was searched on 10 August 2022 to identify published research studies. Literature published in English between 2018 and 2022 were included. Sixty-nine publications were considered relevant, and their full text studied to collate information for this review. Key Content and Findings Lower lung cancer incidence and better prognosis was associated with increased BMI even after accounting for smoking and pre-clinical weight loss. Individuals with high BMI also responded better to treatment modalities such as immunotherapy compared to individuals with a normal BMI. However, these associations varied highly depending on age, gender, and race. Inability of BMI to measure body habitus is the main driver behind this variability. The use of anthropometric indicators and image-based techniques to quantify central obesity easily and accurately is on the rise. Increase in central adiposity is associated with increased incidence and poorer prognosis of lung cancer, contrasting BMI. Conclusions The obesity paradox may arise due to the improper use of BMI as a measure of body composition. Measures of central obesity better portray the deleterious effects of obesity and are more appropriate to be discussed when talking about lung cancer. The use of obesity metrics based on anthropometric measurements and imaging modalities has been shown to be feasible and practical. However, a lack of standardization makes it difficult to interpret the results of studies using these metrics. Further research must be done to understand the association between these obesity metrics and lung cancer.

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“…The interaction between obesity, immunity, and breast cancer progression is complex, and the understanding of this link is an evolving field of research. Studies have demonstrated an increased risk of poor cancer prognosis among obese patients with ectopic fat within organs such as liver, muscle, and heart [8][9][10] . Enlarged adipocytes within ectopic fatty depots leads to the secretion of pro-inflammatory cytokines and metabolic dysregulation that creates a tumorpermissive micro-environment 6 .…”

Section: Introductionmentioning

confidence: 99%

Non-Metastatic Axillary Lymph Nodes Have Distinct Morphology and Immunophenotype in Obese Breast Cancer patients at Risk for Metastasis

Song

Muller

Hondelink

et al. 2023

Preprint

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Obese patients have worse breast cancer outcomes than normal weight women including a 50% to 80% increased rate of axillary nodal metastasis. Recent studies have shown a potential link between increased lymph node adipose tissue and breast cancer nodal metastasis. Further investigation into potential mechanisms underlying this link may reveal potential prognostic utility of fat-enlarged lymph nodes in breast cancer patients. In this study, a deep learning framework was developed to identify morphological differences of non-metastatic axillary nodes between node-positive and node-negative obese breast cancer patients. Pathology review of the model-selected patches found an increase in the average size of adipocytes (p-value=0.004), an increased amount of white space between lymphocytes (p-value<0.0001), and an increased amount of red blood cells (p-value<0.001) in non-metastatic lymph nodes of node-positive breast cancer patients. Our downstream immunohistology (IHC) analysis showed a decrease of CD3 expression and increase of leptin expression in fat-replaced axillary lymph nodes in obese node-positive patients. In summary, our findings suggest a novel direction to further investigate the crosstalk between lymph node adiposity, lymphatic dysfunction, and breast cancer nodal metastases.

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The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer

Cited by 8 publications

References 29 publications

Increased adipose tissue is associated with improved overall survival, independent of skeletal muscle mass in non‐small cell lung cancer

Increased adipose tissue is associated with improved overall survival, independent of skeletal muscle mass in non‐small cell lung cancer

Obesity and lung cancer—a narrative review

Non-Metastatic Axillary Lymph Nodes Have Distinct Morphology and Immunophenotype in Obese Breast Cancer patients at Risk for Metastasis

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