L3 skeletal muscle index (L3SMI) is a surrogate marker of sarcopenia and frailty in non-small cell lung cancer patients
L3 skeletal muscle index (L3SMI) is a surrogate marker of sarcopenia and frailty in non-small cell lung cancer patients
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DOI：
10.2147/cmar.s195869
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Segal, G.
中科院分区：
文献类型：
--
作者：
Portal, D.;Hofstetter, L.;Segal, G.
背景：非小细胞肺癌（NSCLC）是一种常见的高致死率疾病。随着先进治疗方式的发展，人们正在寻求改进的预测方法。L3骨骼肌指数（L3SMI）和丙氨酸转氨酶（ALT）水平是公认的肌肉减少症和相关虚弱的替代标志物。我们的目的是评估这些标志物与NSCLC患者生存的潜在关联。方法：对非小细胞肺癌患者队列进行回顾性、单中心研究。L3SMI是根据计算机断层扫描在L3椎体水平的骨骼肌面积计算的。临床资料从临床图表中提取。结果：本研究共纳入140例患者，其中男性56.4%，中位年龄66岁[37-86]，其中32%诊断为3期，45%诊断为4期。在随访期间（中位1.9年，1个月至6.4年），102例（72.8%）患者死亡。发现与死亡率增加相关的患者特征是表现状态、白蛋白和诊断时的肿瘤分期。肌少症，定义为低L3SMI(女性低于41 cm(2)/m(2)，男性低于53 cm(2)/m(2))，与L3SMI值正常的患者相比，在单因素分析中与更高的死亡风险显著相关（77.2%,vs 64.6%, p=0.013），但在多元回归分析中没有。结论：低L3SMI可以作为肌少症和虚弱的替代标志物，从而促进NSCLC患者的预后过程。
Background: Non-small cell lung cancer (NSCLC) is a common and highly lethal disease. As advanced treatment modalities are being developed, improved prognostication methods are sought. L3 skeletal muscle index (L3SMI) and alanine aminotransferase (ALT) levels are accepted surrogate markers of sarcopenia and related frailty. We aimed to evaluate the potential association of these markers with NSCLC patients' survival.Methods: A retrospective, single-center study of an NSCLC patients' cohort. L3SMI was calculated based on skeletal muscle area on computed tomography scans at the level of the L3 vertebra. Clinical data were extracted from clinical charts.Results: A total of 140 patients (56.4% males, median age 66 [range 37-86]) were included in this study, 32% were diagnosed at stage 3 and 45% at stage 4. During the follow-up duration (median of 1.9 years; range 1 month to 6.4 years), 102 patients (72.8%) died. Patients' characteristics that were found to be associated with increased mortality were performance status, albumin and tumor stage at diagnosis. Sarcopenia, defined as low L3SMI (lower than 41 cm(2)/m(2) for women and lower than 53 cm(2)/m(2) for men) was significantly associated with higher risk of mortality compared with patients with normal L3SMI values (77.2%, vs 64.6%, p=0.013) in univariate analysis, but not in a multiple regression analysis.Conclusion: Low L3SMI could serve as a surrogate marker for sarcopenia and frailty and, as such, facilitate the prognostication process of NSCLC patients.