Kim E Y, Lee H Y, Kim K W, Lee J-I, Kim Y S, Choi W-J, Kim J H
1 Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
2 Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Scand J Surg. 2018 Sep;107(3):244-251. doi: 10.1177/1457496917748221. Epub 2017 Dec 28.
Sarcopenia, reduced skeletal muscle mass, is associated with frailty, injuries, and mortality. The purpose of this study was to evaluate the impact of computed tomography-determined sarcopenia on surgical complications and outcomes after resection of non-small cell lung cancer.
For a total 272 non-small cell lung cancer patients that underwent surgery between 2011 and 2016, cross-sectional area of muscle at the third lumbar vertebra (L3) was retrospectively measured using preoperative chest computed tomography images. Sarcopenia was defined as an L3 muscle index of <55 cm/m for men and of <39 cm/m for women. Clinical characteristics, postoperative complications, disease-free survival, and overall survival of patients with or without sarcopenia were compared.
A total of 60.3% ( n = 164) were male, and mean patient age was 62.9 ± 9.6 years. The prevalence of sarcopenia was 22.4% for all study subjects, 32.9% for men, and 6.5% for women. No significant difference was observed between patients with or without sarcopenia in terms of intensive care unit or hospital stay ( p = 0.502 and p = 0.378, respectively), and the presence of sarcopenia was not associated with postoperative complications. Furthermore, no significant difference was observed between the 3-year disease-free survival rate (74.3% vs 66.7%, p = 0.639) or 3-year overall survival rate (83.9% vs 87.7%, p = 0.563) of patients with or without sarcopenia.
Sarcopenia as determined by preoperative computed tomography does not appear to have a negative impact on surgical outcome or overall survival for resected non-small cell lung cancer patients.
肌肉减少症，即骨骼肌质量减少，与身体虚弱、受伤和死亡率相关。本研究的目的是评估计算机断层扫描测定的肌肉减少症对非小细胞肺癌切除术后手术并发症和结局的影响。
对2011年至2016年间接受手术的272例非小细胞肺癌患者，使用术前胸部计算机断层扫描图像回顾性测量第三腰椎（L3）水平的肌肉横截面积。肌肉减少症的定义为男性L3肌肉指数<55 cm/m²，女性<39 cm/m²。比较有或无肌肉减少症患者的临床特征、术后并发症、无病生存期和总生存期。
共有60.3%（n = 164）为男性，患者平均年龄为62.9±9.6岁。所有研究对象中肌肉减少症的患病率为22.4%，男性为32.9%，女性为6.5%。有或无肌肉减少症的患者在重症监护病房住院时间或住院总时长方面均未观察到显著差异（分别为p = 0.502和p = 0.378），且肌肉减少症的存在与术后并发症无关。此外，有或无肌肉减少症患者的3年无病生存率（74.3%对66.7%，p = 0.639）或3年总生存率（83.9%对87.7%，p = 0.563）均未观察到显著差异。
术前计算机断层扫描测定的肌肉减少症似乎对接受手术的非小细胞肺癌患者的手术结局或总生存期没有负面影响。
