Lower Pectoralis Muscle Area is Associated with a Worse Overall Survival in Non- Small Cell Lung Cancer
Menée à partir de données portant sur 250 patients atteints d'un cancer du poumon non à petites cellules, cette étude évalue l'intérêt d'utiliser un indicateur de la sarcopénie (mesure de la partie inférieure du muscle pectoral par tomodensitométrie au moment du diagnostic) pour évaluer la survie globale
Background: Muscle wasting is a component of the diagnosis of cancer cachexia and has been associated with poor prognosis. However, recommended tools to measure sarcopenia are limited by poor sensitivity or the need to perform additional scans. We hypothesized that pectoralis muscle area (PMA) measured objectively on chest CT scan may be associated with overall survival in non-small cell lung cancer (NSCLC).
Methods: We evaluated two hundred fifty two cases from a prospectively enrolling lung cancer cohort. Eligible cases had CT scans performed prior to the initiation of surgery, radiation, or chemotherapy. PMA was measured in a semi-automated fashion while blinded to characteristics of the tumor, lung, and patient outcomes.
Results: Men had a significantly greater PMA than women (37.59 vs 26.19 cm2, P<0.0001). In univariate analysis, PMA was associated with age and BMI. A Cox proportional hazards model was constructed to account for confounders associated with survival. Lower pectoralis area (per cm2) at diagnosis was associated with an increased hazard of death of 2% (HRadj 0.98 [0.96, 0.99], P=0.044) while adjusting for age, sex, smoking, chronic bronchitis, emphysema, histology, stage, chemotherapy, radiation, surgery, BMI, and ECOG performance status. .
Conclusions: Lower pectoralis muscle area measured from chest CT scans obtained at the time of diagnosis of NSCLC is associated with a worse overall survival.
Impact: Pectoralis muscle area may be a valuable CT biomarker for sarcopenia associated lung cancer survival.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2016