Prevalence and prognostic importance of sarcopenia in patients dwith locally advanced or metastatic NON-small cell lung cancer

Aim: Lung cancer is the most common cancer and most common reason of cancer relevant deaths in the world and our country. There are some factors affecting the quality of life and prognosis in patients with lung cancer. Sarcopenia is a part of cachexia syndrome, which is common in cancer patients, deteriorates the quality of life and causes poor prognosis. Early detection of sarcopenia and understanding the severity of sarcopenia in cancer patients may guide the supportive treatment. The aim of this study was to determine the frequency and level of sarcopenia in patients with locally advanced and metastatic non-small cell lung cancer, and to determine the relationship between the prognosis and the course of sarcopenia in these patients. Materials and Methods: This study included patients admitted to the Ankara Yıldırm Beyazıt University, Ankara Atatürk Training and Researc Hospital, Department of Medical Oncology between January 2013 and January 2018, diagnosed as non-small cell lung cancer, older than 18 years of age, evaluated as local advanced or metastatic disease and whose pre-treatment and post-treatment medical imaging were performed in our hospital. Abdominal computed tomography of the patients before and after treatment was evaluated by the specialist radiologist and the muscle area in the third lumbar section was measured as cm2. Sarcopenia index (cm2/m2) was calculated by dividing the measured muscle area by the height square of the patients. The archives of the patients were scanned and the demographic and clinical data, as well as the values of muscle mass and sarcopenia index measured before and after treatment were transferred to the previously prepared excel files. Data errors were minimized by cross-checking the data. The obtained data were analyzed by uploading to SPSS database. Results: 51 patients were included in study. 48 patients were male and 3 were female. 9 patients were evaluated as locally advanced disease and 42 patients were evaluated as metastatic disease. In the pre-treatment examination of the patients, 44 (86.3%) patients were sarcopenic and 7 (13.7%) patients were non-sarcopenic. When the patients were evaluated according to their body mass indexes, it was observed that the patients who were normal weight at the time of diagnosis were more sarcopenic than the patients who were overweight (p˂0.006). There was a significant decrease in muscle mass and sarcopenia index values during the follow-up of the patients (p˂0,001) but when the interim evaluation and post-treatment values were compared in the patient group receiving chemotherapy, p˂0,039 and p˂0,036 differences were found between muscle mass and sarcopenia index values, respectively. When the patients were evaluated according to the median values of muscle mass and sarcopenia index, there was no significant difference in overall survival and progression-free survival. There was no significant difference in overall survival (p˂0.5) and progression-free survival (p˂0.22) when diagnosed with and without sarcopenia seperated at the time of diagnosis. Conclusion: In this study, no significant relationship was found between sarcopenia and overall survival and progression-free survival. Sarcopenia was present in 44 (86.3%) of 51 patients at the time of diagnosis. Further studies are needed to determine the incidence of sarcopenia in cancer patients and the relationship between sarcopenia and prognosis and to determine the limit values of sarcopenia in this area.