Effect of progressive sarcopenia during postoperative 6 months on long-term prognosis of completely resected lung cancer

This study evaluated whether changes in the skeletal muscle mass index over postoperative 6 months could predict long-term prognosis from 6 months after complete resection of non-small cell lung cancer

Masashi Nagata

2019

Scholarcy highlights

  • Cachexia is a progressive wasting syndrome that accompanies numerous diseases, such as advanced cancer, chronic obstructive pulmonary disease, and cardiac disease, all of which are characterized by muscle loss
  • We have previously reported that preoperative body mass index and C-reactive protein levels correlated with prognosis among smokers after complete resection of lung cancer; this is likely to be related to cachexia progression
  • The present study explored whether the 6-month postoperative change in skeletal muscle mass index as a continuous variable could independently predict long-term prognosis after 6 months of complete lung cancer resection, without considering other risk factors for recurrence such as pathological stage and lymphovascular invasion, in patients with a heavy-smoking history
  • Previous studies on the association between preoperative sarcopenia and postoperative prognosis only demonstrated that sarcopenia is one of the risk factors for prognosis
  • Our study might pave the way for performing clinical trials to assess the impact of perioperative anti-sarcopenia treatments to improve long-term prognosis
  • Categorical and continuous variables that were significantly associated with survival on univariate analyses were included in the multivariate analysis, which was performed using a Cox proportional hazards model constructed using the stepwise method
  • There has been some speculation on whether preoperative sarcopenia indicates the presence micro-residual lesions or micrometastases ; our results showed that recurrence from 6 months after the operation and factors related to lung cancer such as pathological stage were not associated with the decrease of SMI over 6 months after surgery
  • These results suggest that attention should be given to prevention concerning the perioperative progression of sarcopenia for patients after curative resection of lung cancer, especially those who are heavy smokers

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