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Akihiro Nagoya
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P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.16-16 - Calf Circumference Is Associated with Postoperative Outcomes in Lung Cancer Patients Who Underwent Surgery (Now Available) (ID 1764)
10:15 - 18:15 | Presenting Author(s): Akihiro Nagoya
- Abstract
Background
Sarcopenia has gained considerable attention as a poor prognostic factor in lung cancer after surgical resection. Calf circumference (CC) is an easy-to-measure, non-invasive clinical indicator that reflects body muscle mass as well as subcutaneous fat. For this property, many studies have reported that CC is capable of screening sarcopenia, aside from the assessment of nutritional status. In this study, we investigated the association between CC and postoperative outcomes in lung cancer patients.
Method
Between 2007 and 2016, 873 lung cancer patients underwent surgery in our institution. Patients who received induction therapy (n=33), with a prior history of the disease that could affect the diameter of lower limb (n=5), and with missing data (n=17) were excluded in advance, leaving 818 patients for this retrospective analysis. CC was measured prior to surgery in the occasion of hospital admission. We chose 34 cm for men and 33 cm for women as the CC cutoff value for predicting low muscle mass, following the previous report in Japan (Kawakami R et al. Geriatr Gerontol Int.). The patient characteristics, operative factors, and surgical outcomes were examined to compare the groups. The Kaplan-Meier method was used to estimate long-term survival.
Result
The mean age of all patients was 67.9 years. There were 473 men and 345 women, and each of their average CC was 34.4 cm and 32.0 cm. In the smaller CC (s-CC) group (n=427), the average age and the female proportion were significantly higher, whereas BMI, %VC, %FEV1 and %DLco, in addition to the proportion of the other cancer history were significantly lower (P<0.01 each) compared with the other group (n=391). As for operative factors, there were no significant differences in surgical approach, type of resection, operation time and intraoperative bleeding, except that the ratio of systematic hilar and mediastinal lymph node dissection was lower (P<0.01) in the s-CC group. Though overall postoperative complications were equivalent (27.2% vs. 23.0%), complications grade 3 or higher were more frequent in the s-CC group (10.5% vs. 5.9%, P=0.02). The 5-year DFS (65.1% vs. 77.9%, P=0.01) and OS (77.9% vs. 81.7%, P=0.03) were significantly poorer in the s-CC group.
Conclusion
The smaller CC was associated with severe postoperative complications and poor DFS and OS in patients with resected lung cancer. CC was useful for assessing sarcopenia and therefore predicting postoperative outcomes.
