The prognostic value of sarcopenia and sarcopenic obesity in patients with lung cancer receiving immunotherapy: a propensity score matching study.

IF 4.8 2区医学 Q1 ONCOLOGY

Oncologist Pub Date : 2025-06-04 DOI:10.1093/oncolo/oyaf114

Wen Wang, Xintian Xu, Hongming Liu, Yongxia Cui, Qian Han, Tingting Yang, Mengxing Tian, Yu Qian, Xin Jin, Lei Lei

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引用次数: 0

Abstract

Background: Sarcopenic obesity (SO) is a prognostic factor and its impact on response to immunotherapy is still unknown in lung cancer. We aimed to explore the role of SO and body composition in predicting overall survival (OS) in patients with lung cancer receiving immune checkpoint inhibitors (ICIs).

Methods: We conducted a retrospective study involving 119 patients with lung cancer who underwent immunotherapy. The subcutaneous fat area (SFA), visceral fat area (VFA) and skeletal muscle index (SMI) were determined by the cross-sectional computed tomography at the L3 lumbar vertebral level. Sarcopenia and SO were defined by SMI and body mass index. Kaplan-Meier and Cox proportional hazard analyses were used to evaluate the impact of body composition on survival. The propensity score matching (PSM) analysis was used to reduce bias and a nomogram was created to predict the OS.

Results: The Kaplan-Meier survival showed that patients with sarcopenia and SO had poor survival time in the total and PSM cohort. The Cox analyses revealed that sarcopenia (Hazard ratio (HR): 2.04, 95% Confidence Interval (CI): 1.04-4.01, P = 0.039) and SO (HR: 3.17, 95%CI: 1.49-6.75, P = 0.003) were independent OS predictors. SFA and VFA were not associated with OS. The SMI, age, stage, albumin level and SFA were used to develop a nomogram. Patients with high nomogram scores had worse OS (P < 0.0001).

Conclusions: Sarcopenia and SO are prognostic factors in patients with lung cancer receiving ICIs. A nomogram that integrates body composition is sufficiently accurate for predicting OS in patients with lung cancer receiving immunotherapy.

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接受免疫治疗的肺癌患者肌少症和肌少性肥胖的预后价值：倾向评分匹配研究

背景：肌少性肥胖（SO）是肺癌的预后因素，其对免疫治疗反应的影响尚不清楚。我们旨在探讨SO和体成分在预测接受免疫检查点抑制剂（ICIs）治疗的肺癌患者总生存期（OS）中的作用。方法：我们对119例接受免疫治疗的肺癌患者进行回顾性研究。通过腰椎L3段横断面计算机断层扫描测定皮下脂肪面积（SFA）、内脏脂肪面积（VFA）和骨骼肌指数（SMI）。骨骼肌减少症和SO由SMI和体重指数定义。Kaplan-Meier和Cox比例风险分析用于评估身体成分对生存的影响。使用倾向得分匹配（PSM）分析来减少偏差，并创建nomogram来预测OS。结果：Kaplan-Meier生存分析显示，在total和PSM队列中，肌少症和SO患者的生存时间较差。Cox分析显示，肌肉减少症（风险比（HR）： 2.04, 95%可信区间（CI）： 1.04-4.01, P = 0.039）和SO （HR: 3.17, 95%CI: 1.49-6.75, P = 0.003）是独立的OS预测因子。SFA和VFA与OS无相关性。采用SMI、年龄、分期、白蛋白水平和SFA绘制nomogram。结论：肌少症和SO是接受ICIs的肺癌患者的预后因素。整合身体成分的nomogram （nomogram）图足以准确预测接受免疫治疗的肺癌患者的OS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncologist 医学-肿瘤学

CiteScore

10.40

自引率

3.40%

发文量

309

审稿时长

3-8 weeks

期刊介绍： The Oncologist® is dedicated to translating the latest research developments into the best multidimensional care for cancer patients. Thus, The Oncologist is committed to helping physicians excel in this ever-expanding environment through the publication of timely reviews, original studies, and commentaries on important developments. We believe that the practice of oncology requires both an understanding of a range of disciplines encompassing basic science related to cancer, translational research, and clinical practice, but also the socioeconomic and psychosocial factors that determine access to care and quality of life and function following cancer treatment.