Study On The Correlation Between Clinical Characteristics And Prognosis Of Sarcopenia And Advanced Non Small Cell Lung Cancer

BackgroundLung cancer is one of the malignant tumors with high morbidity and mortality,and has become one of the important diseases threatening people’s health.Sarcopenia is an age-related skeletal muscle wasting syndrome characterized by generalized loss of muscle mass,strength,and physical activity.Studies have found that the incidence of sarcopenia in tumor patients is also very high.Sarcopenia associated with malignant tumors is called tumor-associated sarcopenia.Studies have shown that the prevalence of sarcopenia in lung cancer patients is as high as 56%.Sarcopenia is not only associated with adverse reactions to chemotherapy,radiotherapy and postoperative complications,but also can seriously affect patients’ long-term survival.Currently,the research on tumor-associated sarcopenia is in the exploratory stage,and multi-center,large-sample,prospective evidence-based research is needed to reduce the occurrence of related adverse reactions,improve the quality of life of patients,and extend their life span.ObjectiveThis study aims to analyze the clinical characteristics of patients with sarcopenia and the effect of sarcopenia on progression-free survival(PFS)and overall survival(OS)of patients with advanced NSCLC.MethodBy collecting the clinical,imaging and pathological data of 112 patients with advanced NSCLC who received treatment in PLA 455 Hospital from January 2018 to January 2022 and had a definite pathological diagnosis,this study conducted a retrospective analysis on whether patients with advanced NSCLC were complicated with sarcosis.Kaplan-Meier method was used to draw survival curves to compare the survival information of sarcopenia and non-sarcopenia groups,and multivariate cox regression analysis was performed.ResultIn this study.64 patients with advanced NSCLC were diagnosed with sarcopenia.with an incidence of 57.1%.The SMI.body mass index(BMI).lymph node involvement(N0+N1/N2+N3).T-stage of tumor progression(T1+T2/T3+T4)and distant metastasis(present/absent)of patients with and without sarcopenia were statistically statistically significant.The medium and long term prognosis of patients with and without sarcopenia was 6 months(95%CI:5.12～6.88)and 9 months(95%CI:6.26～11.74).the difference was statistically significant(χ2=13.793.P<:0.001);Meanwhile,the median OS was 16 months(95%CI:11.40-20.60)and 25 months(95%CI:18.68-31.32).respectively,and the difference was statistically significant(χ2=5.940.P=0.015).Univariate analysis of PFS in patients with advanced NSCLC showed that age,TNM stage,and the presence of sarcopenia were associated with PFS in patients with advanced NSCLC(P<0.05).The above factors related to PFS were included in multivariate cox regression analysis,and sarcosis(HR=1.739.95%CI:1.146-2.639,P=0.009)and TNM stage(HR=1.717,95%CI:1.136-2.597,P=0.010)were independent influencing factors for PFS in patients with advanced non-small cell lung cancer.Univariate analysis of OS in patients with advanced NSCLC was correlated with gender,lymph node metastasis,distant metastasis,and sarcosis(P<0.05).Multivariate Cox regression analysis was performed on the above factors affecting OS.Results Independent risk factors for OS in advanced NSCLC were associated with sarcopenia(HR=2.097.95%CI:1.308-3.361,P=0.002)and lymph node metastasis(HR=1.638,95%CI:1.081～2.483,P=0.020)..ConclusionThe prevalence of sarcopenia is high in patients with advanced NSCLC.Advanced NSCLC patients with sarcopenia had higher incidence of SMI.body mass index(BMI).lymph node involvement(N0+N1/N2+N3).T-stage of tumor progression(T1+T2/T3+T4),and distant metastasis(with/without).The median PFS and OS of patients with sarcopenia were significantly lower than those without sarcopenia.Combined sarcopenia will be an independent prognostic factor for patients with advanced NSCLC.