Skeletal muscle radiodensity is prognostic for survival in patients with advanced non-small cell lung cancer
Abstract
Background & aims Recent research indicates that severe muscular depletion (sarcopenia) is frequent in cancer patients and linked to cachexia and poor survival. Our aim was to investigate if measures of skeletal muscle hold prognostic information in advanced non-small cell lung cancer (NSCLC).Methods We included NSCLC patients with disease stage IIIB/IV, performance status 0-2, enrolled in three randomised trials of first-line chemotherapy (n = 1305). Computed tomography (CT) images obtained before start of treatment were used for body composition analyses at the level of the third lumbar vertebra (L3). Skeletal muscle mass was assessed by measures of the cross sectional muscle area, from which the skeletal muscle index (SMI) was obtained. Skeletal muscle radiodensity (SMD) was measured as the mean Hounsfield unit (HU) of the measured muscle area. A high level of mean HU indicates a high SMD.Results Complete data were available for 734 patients, mean age 65 years. Both skeletal muscle index (SMI) and muscle radiodensity (SMD) varied largely. Mean SMI and SMD were 47.7 cm 2/m 2 and 37.4 HU in men (n = 420), 39.6 cm 2/m 2 and 37.0 HU in women (n = 314). Multivariable Cox regression analyses, adjusted for established prognostic factors, showed that SMD was independently prognostic for survival (Hazard ratio (HR) 0.98, 95% CI 0.97-0.99, p = 0.001), whereas SMI was not (HR 0.99, 95% CI 0.98-1.01, p = 0.329).Conclusion Low SMD is associated with poorer survival in advanced NSCLC. Further research is warranted to establish whether muscle measures should be integrated into routine practice to improve prognostic accuracy.
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Sjoblom et al. showed that skeletal muscle radiodensity is prognostic for survival in patients with non-small cell lung cancer.
“Sjoblom et al. (2016) showed that skeletal muscle radiodensity is prognostic for survival in patients with non-small cell lung cancer.”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Sjoblom et al., 2016
Those with a higher radiodensity (indicating a lower level of myosteatosis) had increased rates of survival.
“Those with a higher radiodensity (indicating a lower level of myosteatosis) had increased rates of survival.”
From Myosteatosis in the Context of Skeletal Muscle Function Deficit: An Interdisciplinary Workshop at the National Institute on Aging (2020) · cites this paper as Sjoblom et al., 2016
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- Authors
- Sjøblom, B., Grønberg, B. H., Wentzel-Larsen, T., Baracos, V. E., Hjermstad, M. J., Aass, N., Bremnes, R. M., Fløtten, Ø., Bye, A., & Jordhøy, M.
- Affiliations
- Oslo University Hospital (NO)
- Norwegian University of Science and Technology (NO)
- University of Alberta (CA)
- University Hospital of North Norway (NO)
- Haukeland University Hospital (NO)
- University of Oslo (NO)
- Corresponding author
- Sjøblom, Bjørg
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 35
- Issue
- 6
- Pages
- 1386-1393
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2332389425
- Cited by
- 143
- References
- 38
- Citations by year
- 2026: 4 · 2025: 15 · 2024: 8 · 2023: 10 · 2022: 13 · 2021: 19 · 2020: 15 · 2019: 17 · 2018: 23 · 2017: 18 · 2016: 1
- FWCI
- 15.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- skeletal muscle radiodensity, non-small cell lung cancer, sarcopenia, skeletal muscle index, survival prediction, body composition, Hounsfield units, muscle cross-sectional area, first-line chemotherapy, advanced cancer
- MeSH terms
- Aged, Cachexia, Carcinoma, Non-Small-Cell Lung, Female, Humans, Image Processing, Computer-Assisted, Lung Neoplasms, Male, Middle Aged, Prognosis, Tomography, X-Ray Computed, Body Mass Index, Muscle, Skeletal, Sarcopenia
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