Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer.
Sarcopenia is poor risk for unfavorable short- and long-term outcomes in stage I non-small cell lung cancer.
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DOI：
10.21037/atm-20-4380
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发表时间：
2021-03
影响因子：
--
通讯作者：
Kuroda H
中科院分区：
文献类型：
--
作者：
Takahashi Y;Suzuki S;Hamada K;Nakada T;Oya Y;Sakakura N;Matsushita H;Kuroda H
以骨骼肌丢失为特征的肌肉减少症可能通过体力下降和免疫力减弱影响术后结局。我们的目的是探讨肌肉减少症在早期非小细胞肺癌（NSCLC）切除术后的临床意义。我们回顾性分析了315例连续的I期非小细胞肺癌患者，他们接受了肺叶切除术和系统性淋巴结清扫。少肌症定义为高分辨率计算机断层扫描（HRCT）图像上第3椎骨腰大肌面积的最低四分位数。临床病理学变量被用来研究与术后并发症以及总体和无复发生存率的相关性。多变量分析显示，男性[比值比（OR）=5.780，95%可信区间（CI）：2.681-12.500，P<0.001]和肌肉减少症（OR =21.00，95% CI：10.30-42.80，P<0.001）与术后并发症独立相关。与非肌肉减少症组相比，肌肉减少症组的5-总生存率（84.4% vs.69.1%，P<0.001）和无复发生存率（77.2% vs.62.0%，P<0.001）显著降低。在多变量分析中，肌肉减少症是独立的预后因素[风险比（HR）=1.978，95%CI：1.177-3.326，P=0.010]，年龄≥70岁（HR =1.956，95%CI：1.141-3.351，P=0.015）和非腺癌组织学（HR =1.958，95%CI：1.159-3.301，P=0.016）。这是第一个研究表明，术前肌肉减少症是显着相关的不利术后并发症以及长期生存的病理I期非小细胞肺癌。HRCT上这一容易获得的因素可能为考虑可能的手术方式选择和围手术期处理提供有价值的信息。
Sarcopenia characterized by skeletal muscle loss may influence postoperative outcomes through physical decline and weakened immunity. We aimed to investigate clinical significance of sarcopenia in resected early-stage non-small cell lung cancer (NSCLC). We retrospectively reviewed 315 consecutive patients with pathologic stage I NSCLC who had undergone lobectomy with systematic nodal dissection. Sarcopenia was defined as the lowest quartile of psoas muscle area on the 3rd vertebra on the high-resolution computed tomography (HRCT) image. Clinicopathological variables were used to investigate the correlation to postoperative complications as well as overall and recurrence-free survival. Upon multivariable analysis, male sex [odds ratio (OR) =5.780, 95% confidence interval (CI): 2.681–12.500, P<0.001], and sarcopenia (OR =21.00, 95% CI: 10.30–42.80, P<0.001) were independently associated with postoperative complications. The sarcopenia group showed significantly lower 5-over all survival (84.4% vs. 69.1%, P<0.001) and recurrence-free survival (77.2% vs. 62.0%, P<0.001) comparing with the non-sarcopenia group. In a multivariable analysis, sarcopenia was an independent prognostic factor [hazard ratio (HR) =1.978, 95% CI: 1.177–3.326, P=0.010] together with age ≥70 years (HR =1.956, 95% CI: 1.141–3.351, P=0.015) and non-adenocarcinoma histology (HR =1.958, 95% CI: 1.159–3.301, P=0.016). This is the first study which demonstrates that preoperative sarcopenia is significantly associated with unfavorable postoperative complications as well as long-term survival in pathologic stage I NSCLC. This readily available factor on HRCT may provide valuable information to consider possible choice of surgical procedure and perioperative management.
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影响因子：
7.8
作者：
Duggal NA;Upton J;Phillips AC;Sapey E;Lord JM
通讯作者：
Lord JM
DOI：
10.1146/annurev-pathol-121808-102144
发表时间：
2010
期刊：
Annual review of pathology
影响因子：
--
作者：
Coppé JP;Desprez PY;Krtolica A;Campisi J
通讯作者：
Campisi J
DOI：
10.6004/jnccn.2013.0084
发表时间：
2013-06-01
影响因子：
13.4
作者：
Ettinger, David S.;Akerley, Wallace;Hughes, Miranda
通讯作者：
Hughes, Miranda
影响因子：
4.6
作者：
Hervochon, Remi;Bobbio, Antonio;Alifano, Marco
通讯作者：
Alifano, Marco
影响因子：
3.5
作者：
Hanatani, Shinsuke;Izumiya, Yasuhiro;Tsujita, Kenichi
通讯作者：
Tsujita, Kenichi