Kawaguchi Yo, Hanaoka Jun, Ohshio Yasuhiko, Okamoto Keigo, Kaku Ryosuke, Hayashi Kazuki, Shiratori Takuya, Yoden Makoto
Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Tsukinowacho, Seta, Otsu, 502-2192, Shiga, Japan.
Division of General Thoracic Surgery, Kusatsu General Hospital, Kusatsu, Shiga, Japan.
Gen Thorac Cardiovasc Surg. 2019 Nov;67(11):949-954. doi: 10.1007/s11748-019-01125-3. Epub 2019 Apr 10.
Sarcopenia gradually progress with age; hence, it is necessary to define sarcopenia to predict postoperative outcomes in elderly patients with lung cancer. The purpose of this study is to propose a definition of sarcopenia in elderly patients with lung cancer, and to demonstrate the post operative outcomes.
Using computed tomography scans, the cross-sectional area (cm) of the psoas muscle at the third lumbar vertebral level was measured. The psoas area was normalized for height. The psoas muscle mass index was calculated as total psoas muscle area at L3 level/height (cm/m).
A total of 173 patients aged > 75 years of age received lobectomy for non-small cell lung cancer in our hospital. We defined sarcopenia as the psoas muscle mass index under 3.70 cm/m in males and 2.50 cm/m in females, based on the morbidity rate. The postoperative complication rate was significantly higher in patients with sarcopenia (62.5%) than in those without sarcopenia (22.7%). The 5-year survival rate was 26.5% in patients with sarcopenia, and 66.3% in patients without sarcopenia.
In elderly lung cancer patients, sarcopenia was observed to be a high risk for morbidity and predicted poor prognosis.
肌肉减少症随年龄增长而逐渐发展；因此，有必要对肌肉减少症进行定义，以预测老年肺癌患者的术后结局。本研究的目的是提出老年肺癌患者肌肉减少症的定义，并展示术后结局。
使用计算机断层扫描，测量第三腰椎水平腰大肌的横截面积（cm）。腰大肌面积根据身高进行标准化。腰大肌质量指数计算为L3水平的总腰大肌面积/身高（cm/m）。
我院共有173例年龄>75岁的患者接受了非小细胞肺癌肺叶切除术。根据发病率，我们将男性肌肉减少症定义为腰大肌质量指数低于3.70 cm/m，女性低于2.50 cm/m。肌肉减少症患者的术后并发症发生率（62.5%）显著高于无肌肉减少症的患者（22.7%）。肌肉减少症患者的5年生存率为26.5%，无肌肉减少症的患者为66.3%。
在老年肺癌患者中，肌肉减少症被观察到是发病的高风险因素，并预示预后不良。
