Psoas Muscle Volume Is a Useful Predictor of Postoperative Outcome in Elderly Patients With Non-Small Cell Lung Cancer.

BACKGROUND

As the population ages, the number of elderly lung cancer patients has been increasing. While surgery is the best treatment for resectable lung cancer, elderly patients often have multiple comorbidities, making accurate preoperative risk assessment crucial when formulating an appropriate treatment plan. This study aims to explore how psoas muscle volume relates to postoperative outcomes in elderly lung cancer patients.

METHODS

This single-center, retrospective study included 344 elderly (≥ 75) patients who underwent complete surgical resection for non-small cell cancer between 2010 and 2023. The psoas muscle volume index (PVI, cm/m) was measured using a 3-dimensional imaging workstation based on preoperative computed tomography images and grouped based on the median value for each gender. Postoperative complications and survival rates were then compared between the groups.

RESULTS

The median PVI was 60.5 cm/m for males and 47.7 cm/m for females. The PVI-high group had significantly fewer complications (15.6%) than the PVI-low group (37.1%) (p < 0.001). The 5-year overall survival (OS) rate was higher in the PVI-high group (80.5%) than in the PVI-low group (66.7%) (p = 0.01). Multivariate analyses showed that PVI-high was an independent predictor of lower complication risk (odds ratio 0.28, p < 0.001) and an independent factor that improved OS (hazard ratio 0.60, p = 0.042).

CONCLUSIONS

PVI in elderly lung cancer patients is associated with postoperative complications and survival.