Shi Zhihui, Wu Lin, Jiang Dengke, Yang Ruiling, Liao Rui, Liu Lizhu, You Ruimin, Li Yanli, Dong Xingxiang, Zhang Dafu, Wang Jing, Zhang Xuewen, Chen Xiaobo, Li Zhenhui
Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, 650118, China.
Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, 650118, China.
BMC Med Imaging. 2025 Aug 19;25(1):335. doi: 10.1186/s12880-025-01873-0.
Thoracic muscles contribute to respiration, is a crucial indicator for assessing functional recovery following lung resection. However, there is a lack of research on the long-term prognostic value of pectoralis muscle.
Consecutive patients who underwent curative-intent resection for stage I to IIIA NSCLC between 2013 and 2018 at a cancer center were retrospectively identified. The Cox proportional hazard model was employed to analyze the correlation between pectoralis muscle index (PMI) and survival, with subgroup analyses conducted to explore potential heterogeneity among different subgroups. Finally, the relative influence of each parameter was compared using a gradient boosting model (GBM).
A total of 2110 patients (median (IQR) age 59 (52, 66) years) were evaluated. Kaplan-Meier survival analysis showed that the recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) rate of patients in the high PMI group were higher than those in the low PMI group, all with P < 0.001. In the multivariable analysis, low PMI is still associated with shorter RFS (HR = 1.34, 95% CI: (1.10, 1.62), P = 0.004), DMFS (HR = 1.35, 95% CI: (1.11, 1.65), P = 0.003), lung MFS (HR = 1.47, 95% CI: (1.19, 1.81), P < 0.001) and bone MFS (HR = 1.38, 95% CI: (1.11, 1.73), P = 0.004). These associations were consistent in subgroup analysis of different gender, age, tumor stage, histologic type, and surgical approach group.
Low PMI is significantly associated with worse distant metastasis-free survival (DMFS) and recurrence-free survival (RFS) in non-small cell lung cancer (NSCLC) patients, supporting its utility in refining preoperative risk stratification. When CT imaging lacks L3-level coverage, PMI offers a viable alternative for assessing muscle quality.
胸肌对呼吸有作用，是评估肺切除术后功能恢复的关键指标。然而，目前缺乏关于胸大肌长期预后价值的研究。
回顾性纳入2013年至2018年在某癌症中心接受I至IIIA期非小细胞肺癌根治性切除的连续患者。采用Cox比例风险模型分析胸大肌指数（PMI）与生存率之间的相关性，并进行亚组分析以探索不同亚组之间的潜在异质性。最后，使用梯度提升模型（GBM）比较各参数的相对影响。
共评估了2110例患者（中位（IQR）年龄59（52，66）岁）。Kaplan-Meier生存分析显示，高PMI组患者的无复发生存率（RFS）和无远处转移生存率（DMFS）高于低PMI组，均P<0.001。在多变量分析中，低PMI仍与较短的RFS（HR = 1.34，95%CI：（1.10，1.62），P = 0.004）、DMFS（HR = 1.35，95%CI：（1.11，1.65），P = 0.003）、肺转移无进展生存期（lung MFS，HR = 1.47，95%CI：（1.19，1.81），P<0.001）和骨转移无进展生存期（bone MFS，HR = 1.38，95%CI：（1.11，1.73），P = 0.004）相关。这些关联在不同性别、年龄、肿瘤分期、组织学类型和手术方式组的亚组分析中是一致的。
低PMI与非小细胞肺癌（NSCLC）患者较差的无远处转移生存率（DMFS）和无复发生存率（RFS）显著相关，支持其在完善术前风险分层中的作用。当CT成像缺乏L3水平覆盖时，PMI为评估肌肉质量提供了一种可行的替代方法。
