Impact of Sarcopenia on Early Postoperative Complications in Early-Stage Non–Small-Cell Lung Cancer

• Main Authors: Jiyun Lee, Seok Whan Moon, Jung Suk Choi, Kwanyong Hyun, Young Kyu Moon, Mi Hyoung Moon
• Format: Article
• Language: English
• Published: Korean Society for Thoracic and Cardiovascular Surgery 2020-06-01
• Series: Korean Journal of Thoracic and Cardiovascular Surgery
• Subjects: sarcopenia; non–small-cell lung carcinoma; postoperative complications

Background: Risk assessment for pulmonary resection in patients with early-stage non–small-cell lung cancer (NSCLC) is important for minimizing postoperative morbidity. De-pletion of skeletal muscle mass is closely associated with impaired nutritional status and limited physical ability. We evaluated the relationship between skeletal muscle depletion and early postoperative complications in patients with early-stage NSCLC.Methods: Patients who underwent curative lung resection between 2016 and 2018 and who were diagnosed with pathological stage I/II NSCLC were included, and their records were retrospectively analyzed. The psoas volume index (PVI, cm3/m3) was calculated based on computed tomography images from routine preoperative positron emission tomogra-phy-computed tomography. Early postoperative complications, defined as those occur-ring within 90 days of surgery, were compared between the lowest sex-specific quartile for PVI and the remaining quartiles.Results: A strong correlation was found between the volume and the cross-sectional area of the psoas muscle (R2=0.816). The overall rate of complications was 57.6% among patients with a low PVI and 32.8% among those with a normal-to-high PVI. The most common complication was prolonged air leak (low PVI, 16.9%; normal-to-high PVI, 9.6%), followed by pneumonia (low PVI, 13.6%; normal-to-high PVI, 7.9%) and recurrent pleural effusion (low PVI, 11.9%; normal-to-high PVI, 6.8%). The predictors of overall complications were low PVI (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.07–4.09; p=0.03), low hemoglobin level (OR, 0.686; 95% CI, 0.54–0.87; p=0.002), and smoking history (OR, 3.93; 95% CI, 2.03–7.58; p<0.001).Conclusion: Low PVI was associated with a higher rate of early postoperative complica-tions in patients with early-stage NSCLC.