Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary care

José Leão Mendes; Rita Quaresma  Ferreira; Inês  Mata; João Vasco Barreira; Ysel Chiara  Rodrigues; David Silva Dias; Manuel Capelas; Antti Mäkitie; Inês  Guerreiro; Nuno Pimenta; Paula Ravasco

doi:10.20944/preprints202501.1023.v1

Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary care

José Leão Mendes^*, Rita Quaresma Ferreira, Inês Mata, João Vasco Barreira, Ysel Chiara Rodrigues, David Silva Dias, Manuel Capelas, Antti Mäkitie, Inês Guerreiro, Nuno Pimenta, Paula Ravasco

^*Corresponding author for this work

Research output: Working paper › Preprint

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Abstract

Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.

Original language	English
Publisher	Preprints.org
Number of pages	13
DOIs	https://doi.org/10.20944/preprints202501.1023.v1
Publication status	Published - 13 Jan 2025

Keywords

Non-small-cell lung carcinoma
Sarcopenia
Body composition
Prognosis
Biomarkers

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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CIIS: Center for Interdisciplinary Research in Health
Barros, M. (PI), Rosa, N. (Researcher), Correia, M. J. (Researcher), Caldas, A. C. (Researcher), Amado, J. C. (Researcher), Figueiredo, A. S. (Researcher), Esteves, A. C. (Researcher), Mineiro, A. (Researcher), Abreu, A. M. (Researcher), Duarte, A. S. (Researcher), Almeida, S. F. (Researcher), Correia, A. (Researcher), Moura, A. (Researcher), Almeida, A. (Researcher), Araújo, B. (Researcher), Moura-Netto, C. (Researcher), Ferrito, C. (Researcher), Pais-Vieira, C. (Researcher), Festas, C. (Researcher), Marques-Vieira, C. (Researcher), Catré, D. (Researcher), Nunes, E. (Researcher), Jesus, É. (Researcher), Ribeiro, F. (Researcher), Rosário, F. (Researcher), Fernandes, G. (Researcher), Rato, J. R. (Scholarship holder), Salgado, J. R. (Researcher), Neves-Amado, J. (Researcher), Amendoeira, J. (Researcher), Sá, L. (Researcher), Capelas, M. L. (Researcher), Vieira, M. M. (Researcher), Nunes, M. V. S. (Researcher), Cardoso, M. (Researcher), Veiga, N. J. (Researcher), Fonseca, P. (Researcher), Correia, P. N. (Researcher), Couto, P. (Researcher), Pontífice-Sousa, P. (Researcher), Ravasco, P. (Researcher), Carvalho, P. V. D. (Researcher), Alves, P. (Researcher), Melo, P. (Researcher), Silva, R. (Researcher), Canaipa, R. (Researcher), Noites, R. (Researcher), Rio, R. (Researcher), Almeida, S. (Researcher), Deodato, S. (Researcher), Caldeira, S. (Researcher), Silva, S. (Researcher), Borges, T. (Researcher), Silva, V. (Researcher), Charepe, Z. (Researcher), Rodrigues-Pires, F. (Volunteer), Veludo, F. (Researcher), Carmo, H. (Scholarship holder), Romeiro, J. (Student), Melo, M. (Researcher), Braga, M. (Researcher), Amaral, T. (Researcher), Moreira, M. A. (Researcher), Guerra, N. (Student), Santos, P. (Researcher), Paço, S. (Student), Lynce, S. (Scholarship holder), Miguel, S. (Student), Costa, T. (Researcher), Silva-Neves, V. (Researcher), Silva, A. (Researcher), Carvalho, A. R. (Researcher), Almeida, B. (Researcher), Figueiredo, C. (Researcher), Esteves, E. (Scholarship holder), Araújo, F. M. (Researcher), Garcia, J. G. (Researcher), Santos, L. (Researcher), Santos, N. M. D. (Researcher), Lopes, P. (Researcher), Bornes, R. (Researcher), Silva, R. (Researcher), Costa, S. (Researcher), Silva, S. M. (Researcher), Marques, T. (Researcher), Almeida, A. (Researcher), Santos, M. (Scholarship holder), Santos, P. (Researcher), Miguel, S. (Researcher), Mendes, K. (Researcher), Gomes, A. P. (Researcher), Henriques, J. M. P. (Researcher), Costa, H. A. F. P. (Researcher) & Ribeiro, P. (Researcher)
Fundação para a Ciência e a Tecnologia
1/01/20 → 31/12/24
Project: Research

1 Article

Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in portuguese tertiary care
Mendes, J. L., Ferreira, R. Q., Mata, I., Barreira, J. V., Rodrigues, Y. C., Dias, D. S., Capelas, M. L., Mäkitie, A., Guerreiro, I. M., Pimenta, N. M. & Ravasco, P., 5 Feb 2025, In: Cancers. 17, 3, 13 p., 539.
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title = "Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary care",

abstract = "Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.",

keywords = "Non-small-cell lung carcinoma, Sarcopenia, Body composition, Prognosis, Biomarkers",

author = "Mendes, {Jos{\'e} Le{\~a}o} and Ferreira, {Rita Quaresma} and In{\^e}s Mata and Barreira, {Jo{\~a}o Vasco} and Rodrigues, {Ysel Chiara} and Dias, {David Silva} and Manuel Capelas and Antti M{\"a}kitie and In{\^e}s Guerreiro and Nuno Pimenta and Paula Ravasco",

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T1 - Body composition analysis in metastatic non-small-cell lung cancer

T2 - depicting sarcopenia in Portuguese tertiary care

AU - Mendes, José Leão

AU - Ferreira, Rita Quaresma

AU - Mata, Inês

AU - Barreira, João Vasco

AU - Rodrigues, Ysel Chiara

AU - Dias, David Silva

AU - Capelas, Manuel

AU - Mäkitie, Antti

AU - Guerreiro, Inês

AU - Pimenta, Nuno

AU - Ravasco, Paula

PY - 2025/1/13

Y1 - 2025/1/13

N2 - Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.

AB - Background/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (± 11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (< 49.96 cm2/m2 for men; < 34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Conversely, Prado et al. definition lacked prognostic value. Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.

KW - Non-small-cell lung carcinoma

KW - Sarcopenia

KW - Body composition

KW - Prognosis

KW - Biomarkers

U2 - 10.20944/preprints202501.1023.v1

DO - 10.20944/preprints202501.1023.v1

M3 - Preprint

BT - Body composition analysis in metastatic non-small-cell lung cancer

PB - Preprints.org

ER -

Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in Portuguese tertiary care

Abstract

Keywords

UN SDGs

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Body composition analysis in metastatic non-small-cell lung cancer: depicting sarcopenia in portuguese tertiary care

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