Does sarcopenia have any impact on survival of patients with surgically treated non-small-cell lung cancer?

Abstract

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does sarcopenia have any impact on survival of patients with surgically treated non-small-cell lung cancer (NSCLC)?'. Altogether, 342 papers were found using the reported search, of which 9 cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Eight of the studies measured skeletal muscle or total psoas cross-sectional area at the level of the first or third lumbar vertebra normalized for the square of height for defining sarcopenia, while 1 study used absolute measurement of total psoas cross-sectional area. Seven of 8 studies looking at overall survival found that patients with sarcopenia had significantly worse overall survival than those without after surgical resection of NSCLC, while 1 failed to show a difference. Five studies reported disease-free survival, with 3 studies showing no difference and 2 showing that patients with sarcopenia had a significantly worse disease-free survival than those without. One study found that sarcopenia was a predictor of early recurrence in NSCLC patient after surgical resection. Therefore, we conclude that sarcopenia could serve as a predictor of poor prognosis of patients with surgically treated NSCLC.

Keywords: Non-small cell lung cancer; Sarcopenia; Surgery; Survival.