Age-related muscle loss and walking abilities predict outcom
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Lung cancer is a major global cause of mortality. The most common form of lung cancer is non-small-cell lung cancer (NSCLC), and early-stage NSCLCs can often be surgically resected. Unfortunately, some patients still experience poor outcomes after surgical resection. The outcomes of this study say that preoperative paraspinous muscle sarcopenia and poor physical performance help determine the prognosis.

This study was performed to investigate the prognostic significance of preoperative sarcopenia and physical performance in NSCLC. The study was published in the Journal of Cachexia, Sarcopenia, and Muscle.

This retrospective cohort study was performed in NSCLS patients undergoing curative lung resection. The patients were divided into four groups according to the skeletal muscle index [sarcopenia and non?sarcopenia] and 6 min walking distance (6MWD). Sarcopenia was assessed by preoperative cross?sectional areas of right and left paraspinous muscles at the level of the 12th thoracic vertebra from CT images, and physical performance was determined by preoperative 6MWD. The primary and secondary endpoints were postoperative overall survival (OS) and disease?free survival (DFS).

The 587 patients included in the study were divided into the non?sarcopenia/long?distance group, sarcopenia/long?distance group, non?sarcopenia/short?distance group, and sarcopenia/short?distance group.

--A total of 109 deaths and 209 combined endpoints were observed over a mean follow?up of 3.1 ± 1.3 years.

--After adjusting for other covariates, the sarcopenia/short?distance group showed significant associations with shorter OS and DFS compared with the non?sarcopenia/long?distance group on multivariate analyses.

--Although not significant, adding skeletal muscle index and 6MWD to the pre?existing risk model increased the area under the curve on time?dependent receiver operating characteristic curve analysis for OS and DFS, except within 2 years of surgery.

The presence of both preoperative paraspinous muscle sarcopenia and a short distance in 6MWD had an adverse effect on postoperative prognosis in patients with NSCLC, suggesting that preoperative assessment of thoracic sarcopenia and physical performance may be useful for risk stratification of surgical candidates with potential for targeted interventions.