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

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-...

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Veröffentlicht in:Supportive care in cancer 2016-05, Vol.24 (5), p.2075-2084
Hauptverfasser: Go, Se-Il, Park, Mi Jung, Song, Haa-Na, Kang, Myoung Hee, Park, Hee Jung, Jeon, Kyung Nyeo, Kim, Seok-Hyun, Kim, Moon Jin, Kang, Jung-Hun, Lee, Gyeong-Won
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container_issue 5
container_start_page 2075
container_title Supportive care in cancer
container_volume 24
creator Go, Se-Il
Park, Mi Jung
Song, Haa-Na
Kang, Myoung Hee
Park, Hee Jung
Jeon, Kyung Nyeo
Kim, Seok-Hyun
Kim, Moon Jin
Kang, Jung-Hun
Lee, Gyeong-Won
description 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  
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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  &lt; 0.001), as was PFS (median 3.2 vs. 7.7 vs. 7.6 vs. 7.1 months, respectively, p  &lt; 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  &lt; 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.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-015-2997-x</identifier><identifier>PMID: 26546456</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cancer ; Care and treatment ; Chemoradiotherapy - mortality ; Chemotherapy ; CT imaging ; Development and progression ; Diagnostic imaging ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Inflammation - mortality ; Inflammation - pathology ; Lung cancer ; Lung cancer, Small cell ; Lung Neoplasms - drug therapy ; Lung Neoplasms - mortality ; Lung Neoplasms - physiopathology ; Lymphocytes ; Male ; Medical colleges ; Medical prognosis ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neutrophils - drug effects ; Nursing ; Nursing Research ; Oncology ; Original Article ; Pain Medicine ; Patient outcomes ; Prognosis ; Rehabilitation Medicine ; Retrospective Studies ; Sarcopenia ; Sarcopenia - mortality ; Sarcopenia - pathology ; Small Cell Lung Carcinoma - drug therapy ; Small Cell Lung Carcinoma - mortality ; Small Cell Lung Carcinoma - physiopathology</subject><ispartof>Supportive care in cancer, 2016-05, Vol.24 (5), p.2075-2084</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>COPYRIGHT 2016 Springer</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-2221a84ef17c9e58f374b29433c336b6289fa6e3e6b5309732c52ab5a89cd7c73</citedby><cites>FETCH-LOGICAL-c439t-2221a84ef17c9e58f374b29433c336b6289fa6e3e6b5309732c52ab5a89cd7c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-015-2997-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-015-2997-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26546456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Go, Se-Il</creatorcontrib><creatorcontrib>Park, Mi Jung</creatorcontrib><creatorcontrib>Song, Haa-Na</creatorcontrib><creatorcontrib>Kang, Myoung Hee</creatorcontrib><creatorcontrib>Park, Hee Jung</creatorcontrib><creatorcontrib>Jeon, Kyung Nyeo</creatorcontrib><creatorcontrib>Kim, Seok-Hyun</creatorcontrib><creatorcontrib>Kim, Moon Jin</creatorcontrib><creatorcontrib>Kang, Jung-Hun</creatorcontrib><creatorcontrib>Lee, Gyeong-Won</creatorcontrib><title>Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>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  &lt; 0.001), as was PFS (median 3.2 vs. 7.7 vs. 7.6 vs. 7.1 months, respectively, p  &lt; 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  &lt; 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Chemoradiotherapy - mortality</subject><subject>Chemotherapy</subject><subject>CT imaging</subject><subject>Development and progression</subject><subject>Diagnostic imaging</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Inflammation - mortality</subject><subject>Inflammation - pathology</subject><subject>Lung cancer</subject><subject>Lung cancer, Small cell</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - physiopathology</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Neutrophils - drug effects</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Rehabilitation Medicine</subject><subject>Retrospective Studies</subject><subject>Sarcopenia</subject><subject>Sarcopenia - mortality</subject><subject>Sarcopenia - pathology</subject><subject>Small Cell Lung Carcinoma - drug therapy</subject><subject>Small Cell Lung Carcinoma - mortality</subject><subject>Small Cell Lung Carcinoma - physiopathology</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUtv1TAQhSMEoreFH8AGWWLDJsXPOF5WVYFKlVgAa8txJhdXiR3spI8Vf52JbnkKZMmWxt85mplTVS8YPWWU6jeFUsVpTZmquTG6vntU7ZgUotZCmMfVjhrJaimUOqqOS7mmlGmt-NPqiDdKNlI1u-rbR5d9miEGR1zsSYjD6KbJLSFF4jJgoQf87iEuZM7QB7-kXEgaSFnzTbhxIyJkciOQGVWIFRLhdrwnfXD7mAr05DYsX0hBZiQe8BrXuCfeRQ_5WfVkcGOB5w_vSfX57cWn8_f11Yd3l-dnV7WXwiw155y5VsLAtDeg2kFo2XGDs3ohmq7hrRlcAwKaTglqtOBecdcp1xrfa6_FSfX64Dvn9HWFstgplK0ZFyGtxeJmGtq2Rmzoq7_Q67TmiN1tFNq3LRW_qD2ObnFtacnOb6b2TEotmFBSIXX6DwpPD1PwKcIQsP6HgB0EPqdSMgx2zmFy-d4yarfQ7SF0i6HbLXR7h5qXDw2v3QT9T8WPlBHgB6DgV9xD_m2i_7p-BwDat2U</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Go, Se-Il</creator><creator>Park, Mi Jung</creator><creator>Song, Haa-Na</creator><creator>Kang, Myoung Hee</creator><creator>Park, Hee Jung</creator><creator>Jeon, Kyung Nyeo</creator><creator>Kim, Seok-Hyun</creator><creator>Kim, Moon Jin</creator><creator>Kang, Jung-Hun</creator><creator>Lee, Gyeong-Won</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160501</creationdate><title>Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer</title><author>Go, Se-Il ; Park, Mi Jung ; Song, Haa-Na ; Kang, Myoung Hee ; Park, Hee Jung ; Jeon, Kyung Nyeo ; Kim, Seok-Hyun ; Kim, Moon Jin ; Kang, Jung-Hun ; Lee, Gyeong-Won</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-2221a84ef17c9e58f374b29433c336b6289fa6e3e6b5309732c52ab5a89cd7c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Chemoradiotherapy - mortality</topic><topic>Chemotherapy</topic><topic>CT imaging</topic><topic>Development and progression</topic><topic>Diagnostic imaging</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Inflammation - mortality</topic><topic>Inflammation - pathology</topic><topic>Lung cancer</topic><topic>Lung cancer, Small cell</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - physiopathology</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Middle Aged</topic><topic>Neutrophils - drug effects</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Rehabilitation Medicine</topic><topic>Retrospective Studies</topic><topic>Sarcopenia</topic><topic>Sarcopenia - mortality</topic><topic>Sarcopenia - pathology</topic><topic>Small Cell Lung Carcinoma - drug therapy</topic><topic>Small Cell Lung Carcinoma - mortality</topic><topic>Small Cell Lung Carcinoma - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Go, Se-Il</creatorcontrib><creatorcontrib>Park, Mi Jung</creatorcontrib><creatorcontrib>Song, Haa-Na</creatorcontrib><creatorcontrib>Kang, Myoung Hee</creatorcontrib><creatorcontrib>Park, Hee Jung</creatorcontrib><creatorcontrib>Jeon, Kyung Nyeo</creatorcontrib><creatorcontrib>Kim, Seok-Hyun</creatorcontrib><creatorcontrib>Kim, Moon Jin</creatorcontrib><creatorcontrib>Kang, Jung-Hun</creatorcontrib><creatorcontrib>Lee, Gyeong-Won</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database (ProQuest)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Go, Se-Il</au><au>Park, Mi Jung</au><au>Song, Haa-Na</au><au>Kang, Myoung Hee</au><au>Park, Hee Jung</au><au>Jeon, Kyung Nyeo</au><au>Kim, Seok-Hyun</au><au>Kim, Moon Jin</au><au>Kang, Jung-Hun</au><au>Lee, Gyeong-Won</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>24</volume><issue>5</issue><spage>2075</spage><epage>2084</epage><pages>2075-2084</pages><issn>0941-4355</issn><eissn>1433-7339</eissn><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  &lt; 0.001), as was PFS (median 3.2 vs. 7.7 vs. 7.6 vs. 7.1 months, respectively, p  &lt; 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  &lt; 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26546456</pmid><doi>10.1007/s00520-015-2997-x</doi><tpages>10</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Cancer
Care and treatment
Chemoradiotherapy - mortality
Chemotherapy
CT imaging
Development and progression
Diagnostic imaging
Disease-Free Survival
Female
Follow-Up Studies
Humans
Inflammation
Inflammation - mortality
Inflammation - pathology
Lung cancer
Lung cancer, Small cell
Lung Neoplasms - drug therapy
Lung Neoplasms - mortality
Lung Neoplasms - physiopathology
Lymphocytes
Male
Medical colleges
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Neutrophils - drug effects
Nursing
Nursing Research
Oncology
Original Article
Pain Medicine
Patient outcomes
Prognosis
Rehabilitation Medicine
Retrospective Studies
Sarcopenia
Sarcopenia - mortality
Sarcopenia - pathology
Small Cell Lung Carcinoma - drug therapy
Small Cell Lung Carcinoma - mortality
Small Cell Lung Carcinoma - physiopathology
title Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer
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