Body Composition as Prognostic Markers for Survival of Patients with Non-Metastatic Non-Small-Cell Lung Cancer

Abstract

Objective: Lung cancer is the leading cause of cancer-related deaths. Although, previous research have shown that patients with non-small-cell lung cancer (NSCLC), with a higher body mass index (BMI), have a lower risk of death, only a few studies have examined the effects of body composition. Hence, this study examined the prognostic value of skeletal muscle mass and fat mass in patients with non-metastatic NSCLC. Material and Methods: This was a retrospective cohort study; from 2008 to 2012. Eighty-eight of 130 non-metastatic NSCLC patients underwent computed tomography to assess paravertebral skeletal muscle, subcutaneous adipose tissue (SAT), and visceral adipose-tissue (VAT) at the 3rd lumbar vertebral level. Spearman correlation analysis was used to analyze body-composition correlations. Cox regression analysis was used to determine prognostic markers. Results: Higher SAT and VAT indices were associated with a higher-survival probability (HR, 0.79; p-value=0.001 and, HR 0.88; p-value=0.016, respectively). In contrast, higher SAT density and VAT/SAT ratio were associated with a lower survival probability (HR 1.16, p-value=0.012; HR 1.28, p-value=0.006, respectively). Lower performance status and TNM stage 3 were associated with lower-survival probability (HR 2.60; p-value=0.004, HR 1.92; p-value=0.035, respectively).Conclusion: The VAT index predicts a better prognosis for patients with non-metastatic lung cancer; however, visceral-fat distribution, as measured by a high VAT/SAT ratio, is associated with a worse prognosis.