Myosteatosis may influence survival of patients with #lung #cancer in many ways. Do ⬆️ myosteatosis markers on chest CT before early-stage #NSCLC resection predict worse survival? #RadInTraining #Tweetorial of a study just published in @radiology_rsna @RITEditor @VChernyakMD
Cardiopulmonary evaluation is used to stratify the pre-op risk of NSCLC patients but is an imperfect estimator of long-term survival 💡Data on association of muscle mass w/ survival in NSCLC are inconclusive, & muscle quality may be a better estimator
CT markers of myosteatosis have been associated with poor survival in cancer patients 🎯This study assesses if ⬆️ myosteatosis markers on chest CT before lung resection of early-stage NSCLC are associated with and predictive of worse overall survival (OS)
Retrospective study including patients with stage 0-IIB NSCLC who underwent lobectomy or bilobectomy at 3 hospitals. Chest CT was analyzed at the T12 level with semiautomated threshold-based segmentation by 2 readers.
Measurement of: ✅ Skeletal muscle index (SMI, cross sectional area/height) and density (SMD, mean HU) ✅ Subcutaneous adipose tissue (SAT) index and density ✅ Intermuscular adipose tissue (IMAT) index and density
✏️ Associations of SMD and IMAT index with OS assessed via separate Cox proportional hazard models, adjusted for SMI, SAT, confounders
👥 838 patients (median age 68y, 363 M), most of them of stage ≤IB NSCLC 219 died after a median FU of 5.3y
📍Key results Myosteatosis (⬇️SMD and ⬆️IMAT index) was associated with worse OS (aHR 0.87, p<0.001 and 1.24, p<0.001) No associations between OS and SMI, SAT index & density Predictive performance for OS increased from 0.723 to 0.731 after including myosteatosis markers.
Myosteatosis was also associated with: ➡️ worse lung cancer-specific survival (SMD, aHR 0.84, p<0.001, IMAT aHR 1.27, p=0.005). ➡️ higher odds of pulmonary post-op events (SMD, aOR 0.83, p=0.005, IMAT aOR 1.56, p=0.002)
📍 In conclusion, myosteatosis markers on pre-op chest CT measured at T12 level are associated with worse OS following resection of stage 0-IIB NSCLC independent of the SMI and subcutaneous adipose tissue, and may improve prognostication.
🚨Read the full article in @radiology_rsna at �pubs.rsna.org/doi/10.1148/ra…5E #RadInTraining @RITEditor @VChernyakMD @DrLindaMoy @RadiologyEditor
