NSCLC: sarcopenia is linked to worse outcomes after surgery

  • Shinohara S & al.
  • Ann Surg Oncol
  • 22 Jan 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Sarcopenia is significantly associated with worse OS and PFS, but not with increased risk for postoperative complications in patients with NSCLC who underwent surgical resection with curative intent.

Why this matters

  • Patients with NSCLC undergoing curative surgery should receive a preoperative CT to determine the presence of sarcopenia.

Study design

  • 391 people with NSCLC underwent curative surgical resection.
  • Median follow-up, 55.3 months.
  • Funding: None disclosed.

Key results

  • 50.6% had preoperatively diagnosed sarcopenia.
  • 19.4% underwent sublobar resection, 79.8% lobectomy, and 0.8% pneumonectomy.
  • Patients with sarcopenia had worse outcomes than those without:
    • 5-year OS: 59.0% vs 87.5% (P<.001>
    • 5-year RFS: 47.8% vs 75.6% (P<.001>
    • Cancer-specific mortality: 18.7% vs 9.3% (P=.009).
    • Respiratory-related mortality: 16.6% vs 1.6% (P<.001>
  • After multivariate analysis, sarcopenia was significantly associated with:
    • Worse OS: aHR, 3.33 (P<.001>
    • Worse RFS: aHR, 2.76; P<.001>
    • But not with increased risk for postoperative complications.
  • After propensity matching, sarcopenia was associated with pneumonia after discharge (24.0% vs 12.4%; P=.023).
  • Among patients with sarcopenia, there was no survival disadvantage from limited surgery compared with standard surgery.

Limitations

  • Single-center retrospective study.