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Supportive Care in Cancer
Published in: Supportive Care in Cancer 5/2016

01-05-2016 | Original Article

Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer

Authors: Se-Il Go, Mi Jung Park, Haa-Na Song, Myoung Hee Kang, Hee Jung Park, Kyung Nyeo Jeon, Seok-Hyun Kim, Moon Jin Kim, Jung-Hun Kang, Gyeong-Won Lee

Published in: Supportive Care in Cancer | Issue 5/2016

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Abstract

Purpose

Sarcopenia is suggested to be associated with cancer-related inflammation. We assessed the clinical outcome of small cell lung cancer (SCLC) patients according to sarcopenia and the neutrophil-to-lymphocyte ratio (NLR).

Methods

A total of 117 male SCLC patients treated with first-line chemo- or chemoradiotherapy were assessed based on a retrospective chart review. The mass of the pectoralis muscle was measured by computed tomography and normalized to height. Patients with the lowest quartile of muscle mass were considered to have sarcopenia. Patients were classified into four groups according to their sarcopenia and NLR statuses: sarcopenia/high NLR, sarcopenia/low NLR, non-sarcopenia/high NLR, and non-sarcopenia/low NLR.

Results

Sarcopenic patients had lower progression-free survival (PFS) than did non-sarcopenic patients (median 6.0 vs. 7.5 months, p = 0.009), but the difference in overall survival (OS) was not statistically significant (median 10.5 vs. 13.5 months, p = 0.052). However, the OS of sarcopenic patients with high NLR was significantly lower than that in all other groups (median 3.2 vs. 16.0 vs. 12.5 vs. 13.7 months, respectively, p < 0.001), as was PFS (median 3.2 vs. 7.7 vs. 7.6 vs. 7.1 months, respectively, p < 0.001). On multivariate analysis, sarcopenia with high NLR was an independent prognostic factor for shorter PFS and OS. Early discontinuation of treatment (20.0 vs. 10.3 %) and treatment-related mortality (50.0 vs. 8.4 %) occurred more frequently in these patients than in the other groups (p < 0.001).

Conclusions

In SCLC, sarcopenic male patients with high NLR have a poor prognosis and do not tolerate standard treatment. Intensive supportive care is needed in these patients.
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Metadata
Title
Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer
Authors
Se-Il Go
Mi Jung Park
Haa-Na Song
Myoung Hee Kang
Hee Jung Park
Kyung Nyeo Jeon
Seok-Hyun Kim
Moon Jin Kim
Jung-Hun Kang
Gyeong-Won Lee
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 5/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2997-x

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