Table Info

Table 5.

Univariate and multivariate analyses of possible risk factors for OS and PFS by Cox proportional hazards model

Parameter	OS univariate P-value	OS multivariate P-value	PFS univariate P-value	PFS multivariate P-value
Age	0.01	0.086	0.331	-
Smoking history	0.01	0.533	0.501	-
BMI	0.007	0.267	0.215	-
Pre-chemotherapy sarcoepnia	0	0	0	0.446
Pre-chemotherapy SMD	0.005	0.132	0.001	0.781
Pre-chemotherapy ALI	0.033	0.45	0.377	-
Pre-chemotherapy mALI	0.012	0.135	0.414	-
Pre-chemotherapy NLR	0.148	-	0.208	-
Post-chemotherapy sarcoepnia	0	0.001	0	0.001
Post-chemotherapy SMD	0.001	0.047	0	0.292
Post-chemotherapy mALI	0	0.034	0.077	-
Post-chemotherapy NLR	0.022	0.418	0.348	-

-: not applicable. Bold values indicate significant P-values

Declarations

Author contributions

AM: Conceptualization, Project administration, Investigation, Methodology, Supervision, Validation, Writing—review & editing. DG: Conceptualization, Data curation, Formal analysis, Investigation, Writing—review & editing, Writing—original draft, Software. UA, KP, VN, AJ, NM, VP, and SS: Data curation, Investigation. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was conducted after clearance from Institutional Ethics Committee (3088; Tata Memorial Hospital) and conducted in accordance with the guidelines of the Indian Council of Medical Research 2017. The research of this article meets the requirements of the Declaration of Helsinki.

Consent to participate

Informed consent to participate in the study was obtained from all participants.

Consent to publication

Informed consent to publication was obtained from relevant participants.

Availability of data and materials

The datasets generated in this study are available on request to Abhishek Mahajan (drabhishek.mahajan@yahoo.in; abhiradiology@gmail.com).

Funding

Not applicable.

Copyright

References

Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. Lancet Oncol. 2008;9:629–35. [DOI] [PubMed]

Prado CM, Baracos VE, McCargar LJ, Mourtzakis M, Mulder KE, Reiman T, et al. Body composition as an independent determinant of 5-fluorouracil–based chemotherapy toxicity. Clin Cancer Res. 2007;13:3264–8. [DOI] [PubMed]

Antoun S, Baracos VE, Birdsell L, Escudier B, Sawyer MB. Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. Ann Oncol. 2010;21:1594–8. [DOI] [PubMed]

Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. Br J Cancer. 2012;107:931–6. [DOI] [PubMed] [PMC]

Cecchini S, Cavazzini E, Marchesi F, Sarli L, Roncoroni L. Computed tomography volumetric fat parameters versus body mass index for predicting short-term outcomes of colon surgery. World J Surg. 2011;35:415–23. [DOI] [PubMed]

Moon HG, Ju YT, Jeong CY, Jung EJ, Lee YJ, Hong SC, et al. Visceral obesity may affect oncologic outcome in patients with colorectal cancer. Ann Surg Oncol. 2008;15:1918–22. [DOI] [PubMed]

Balentine CJ, Enriquez J, Fisher W, Hodges S, Bansal V, Sansgiry S, et al. Intra-abdominal fat predicts survival in pancreatic cancer. J Gastrointest Surg. 2010;14:1832–7. [DOI] [PubMed]

Yavuzsen T, Davis MP, Walsh D, LeGrand S, Lagman R. Systematic review of the treatment of cancer-associated anorexia and weight loss. J Clin Oncol. 2005;23:8500–11. [DOI] [PubMed]

He X, Zhou T, Yang Y, Hong S, Zhan J, Hu Z, et al. Advanced lung cancer inflammation index, a new prognostic score, predicts outcome in patients with small-cell lung cancer. Clin Lung Cancer. 2015;16:e165–71. [DOI] [PubMed]

10.

Yip C, Dinkel C, Mahajan A, Siddique M, Cook GJ, Goh V. Imaging body composition in cancer patients: visceral obesity, sarcopenia and sarcopenic obesity may impact on clinical outcome. Insights Imaging. 2015;6:489–97. [DOI] [PubMed] [PMC]

11.

World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i–xii, 1–253. [PubMed]

12.

Aubrey J, Esfandiari N, Baracos VE, Buteau FA, Frenette J, Putman CT, et al. Measurement of skeletal muscle radiation attenuation and basis of its biological variation. Acta Physiol (Oxf). 2014;210:489–97. [DOI] [PubMed] [PMC]

13.

Kobayashi S, Karube Y, Inoue T, Araki O, Maeda S, Matsumura Y, et al. Advanced lung cancer inflammation index predicts outcomes of patients with pathological stage IA lung adenocarcinoma following surgical resection. Ann Thorac Cardiovasc Surg. 2019;25:87–94. [DOI] [PubMed] [PMC]

14.

Tomita M, Ayabe T, Maeda R, Nakamura K. Combination of advanced lung cancer inflammation index and C-reactive protein is a prognostic factor in patients with operable non-small cell lung cancer. World J Oncol. 2017;8:175–9. [DOI] [PubMed] [PMC]

15.

Kim EY, Kim N, Kim YS, Seo JY, Park I, Ahn HK, et al. Prognostic significance of modified advanced lung cancer inflammation index (ALI) in patients with small cell lung cancer_ comparison with original ALI. PloS One. 2016;11:e0164056. [DOI] [PubMed] [PMC]

16.

Jafri SH, Shi R, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): a retrospective review. BMC cancer. 2013;13:158. [DOI] [PubMed] [PMC]

17.

Shiroyama T, Suzuki H, Tamiya M, Tamiya A, Tanaka A, Okamoto N, et al. Pretreatment advanced lung cancer inflammation index (ALI) for predicting early progression in nivolumab‐treated patients with advanced non-small cell lung cancer. Cancer Med. 2018;7:13–20. [DOI] [PubMed] [PMC]

18.

Diem S, Schmid S, Krapf M, Flatz L, Born D, Jochum W, et al. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers in patients with non-small cell lung cancer (NSCLC) treated with nivolumab. Lung Cancer. 2017;111:176–81. [DOI] [PubMed]

19.

Buentzel J, Heinz J, Bleckmann A, Bauer C, Röver C, Bohnenberger H, et al. Sarcopenia as prognostic factor in lung cancer patients: a systematic review and meta-analysis. Anticancer Res. 2019;39:4603–12. [DOI] [PubMed]

20.

Yang M, Shen Y, Tan L, Li W. Prognostic value of sarcopenia in lung cancer: a systematic review and meta-analysis. Chest. 2019;156:101–11. [DOI] [PubMed]

21.

Anjanappa M, Corden M, Green A, Roberts D, Hoskin P, McWilliam A, et al. Sarcopenia in cancer: risking more than muscle loss. Tech Innov Patient Support Radiat Oncol. 2020;16:50–7. [DOI] [PubMed] [PMC]

22.

Beaudart C, Dawson A, Shaw SC, Harvey NC, Kanis JA, Binkley N, et al.; IOF-ESCEO Sarcopenia Working Group. Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporos Int. 2017;28:1817–33. [DOI] [PubMed] [PMC]

23.

Beckwée D, Delaere A, Aelbrecht S, Baert V, Beaudart C, Bruyere O, et al.; Sarcopenia Guidelines Development Group of the Belgian Society of Gerontology and Geriatrics (BSGG). Exercise interventions for the prevention and treatment of sarcopenia. A systematic umbrella review. J Nutr Health Aging. 2019;23:494–502. [DOI] [PubMed]

24.

Chen HT, Chung YC, Chen YJ, Ho SY, Wu HJ. Effects of different types of exercise on body composition, muscle strength, and IGF‐1 in the elderly with sarcopenic obesity. J Am Geriatr Soc. 2017;65:827–32. [DOI] [PubMed]

25.

Harber MP, Konopka AR, Undem MK, Hinkley JM, Minchev K, Kaminsky LA, et al. Aerobic exercise training induces skeletal muscle hypertrophy and age-dependent adaptations in myofiber function in young and older men. J Appl Physiol (1985). 2012;113:1495–504. [DOI] [PubMed] [PMC]

26.

Geirsdottir OG, Arnarson A, Ramel A, Briem K, Jonsson PV, Thorsdottir I. Muscular strength and physical function in elderly adults 6–18 months after a 12-week resistance exercise program. Scand J Public Health. 2015;43:76–82. [DOI] [PubMed]

27.

White Z, Terrill J, White RB, McMahon C, Sheard P, Grounds MD, et al. Voluntary resistance wheel exercise from mid-life prevents sarcopenia and increases markers of mitochondrial function and autophagy in muscles of old male and female C57BL/6J mice. Skelet Muscle. 2016;6:45. Erratum in: Skelet Muscle. 2017;7:4. [DOI] [PubMed] [PMC]

28.

Nishimura JM, Ansari AZ, D’Souza DM, Moffatt-Bruce SD, Merritt RE, Kneuertz PJ. Computed tomography-assessed skeletal muscle mass as a predictor of outcomes in lung cancer surgery. Ann Thorac Surg. 2019;108:1555–64. [DOI] [PubMed]

29.

Wang J, Cao L, Xu S. Sarcopenia affects clinical efficacy of immune checkpoint inhibitors in non-small cell lung cancer patients: a systematic review and meta-analysis. Int Immunopharmacology. 2020;88:106907. [DOI] [PubMed]

30.

Takenaka Y, Oya R, Takemoto N, Inohara H. Predictive impact of sarcopenia in solid cancers treated with immune checkpoint inhibitors: a meta‐analysis. J Cachexia Sarcopenia Muscle. 2021;12:1122–35. [DOI] [PubMed] [PMC]

31.

Deng HY, Chen ZJ, Qiu XM, Zhu DX, Tang XJ, Zhou Q. Sarcopenia and prognosis of advanced cancer patients receiving immune checkpoint inhibitors: a comprehensive systematic review and meta-analysis. Nutrition. 2021;90:111345. [DOI] [PubMed]

32.

Lee D, Kim NW, Kim JY, Lee JH, Noh JH, Lee H, et al. Sarcopenia’s prognostic impact on patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis. J Clin Med. 2021;10:5329. [DOI] [PubMed] [PMC]

33.

Kawaguchi Y, Hanaoka J, Ohshio Y, Okamoto K, Kaku R, Hayashi K, et al. Does sarcopenia affect postoperative short-and long-term outcomes in patients with lung cancer?— a systematic review and meta-analysis. J Thorac Dis. 2021;13:1358–69. [DOI] [PubMed] [PMC]