Author of

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  P05 - Early Stage/Localized Disease - Radiotherapy (ID 114)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Early Stage/Localized Disease
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 34971

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    P05.11 - Preoperative Low Muscle Quality Predicts Poor Outcomes After Surgery for Early-Stage Non-Small Cell Lung Cancer (ID 2047)

    00:00 - 00:00  |  Presenting Author(s): Atsushi Kamigaichi
    • Abstract
    • Slides

    Introduction
    

    Sarcopenia, defined as low skeletal muscle mass, is known as a prognostic factor for cancer. Recently, the quality of skeletal muscle as a new parameter of sarcopenia has gained attention in liver cancer. This study investigated the impact of the quality of skeletal muscle in the outcomes of patients undergoing surgery for early-stage non-small cell lung cancer (NSCLC).

    Methods
    

    A total of 98 patients with pathological stage I–II NSCLC, who underwent lobectomy or segmentectomy, were retrospectively analyzed. The quality of skeletal muscle was evaluated by intramuscular adipose tissue content (IMAC), calculated preoperatively as the ratio of CT attenuation value of the paravertebral muscles (HU) to the subcutaneous fat (HU) at the first lumbar vertebral level. Patients were separated into two groups according to median IMAC. A higher IMAC indicates a greater amount of adipose tissue within skeletal muscle, hence, a lower quality of skeletal muscle. The prognosis of patients with high IMAC was compared with that of the patients with normal IMAC.

    Results
    

    The median follow-up duration was 59 months. Patients with high IMAC are aged (P = 0.01). No significant differences in body mass (weight/height²) and skeletal mass (SMI) (area/height²) indexes between groups were observed. The overall survival (OS) and recurrence-free survival (RFS) rates were significantly lower in patients with high IMAC (n = 49; 5-year OS, 89.8%; and 5-year RFS, 78.9% vs normal IMAC, n = 49; 5-year OS, 98.0%; and 5-year RFS, 93.9%; P = 0.014 and P = 0.023, respectively). The disease-specific survival (DSS) was not significantly different between groups (high IMAC: 5-year DSS, 91.7%; normal IMAC: 5-year DSS, 98.0%; P = 0.09). Multivariate analysis showed that high IMAC (hazard ratio [HR] 13.6, P = 0.032), low SMI (HR 16.1, P = 0.031), and pleural invasion (HR 8.04, P = 0.037) were independently associated with worse OS.

    Conclusion
    

    IMAC was closely related to survival in this study population. The quality of skeletal muscle evaluated by IMAC could be a new predictive parameter of sarcopenia and risk factor after surgery for early-stage NSCLC.

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