The objective of this study is to examine the association between sarcopenia and the prognostic nutritional index (PNI) with treatment response and survival in patients with advanced metastatic non-small cell lung cancer

Objective: Sarcopenia is a component of cachexia syndrome, a condition that is prevalent in cancer patients and is associated with a reduction in quality of life and an unfavorable prognosis. Recently, studies employing the prognostic nutritional index (PNI) and sarcopenia parameters have garnered significant attention. In these studies, the effects of sarcopenia and PNI on survival were examined separately. The objective of this study was to evaluate the relationship between sarcopenia and nutritional parameters and the effects of changes in sarcopenia and nutritional parameters on survival, prognosis, and toxicity in advanced metastatic non-small cell lung cancer patients. Methods: The data of advanced metastatic non-small cell lung cancer patients admitted to the Medical Oncology outpatient clinic of Akdeniz University Hospital between 2014 and 2021 were retrospectively reviewed. A total of 155 patients with complete data were included in the study. The prognostic nutritional index (PNI) was calculated before and after treatment, and skeletal muscle area was measured at the Th11 vertebra level from computed tomography examinations. Result: Of the patients, 125 (80.6%) were male and 30 (19.4%) were female. 45.8% of patients were active smokers. The most common histology was adenocarcinoma with 64.5%, squamous cell carcinoma with 23.2% and adenosquamous carcinoma with 6.5%.The most common sites of metastasis were bone (56.1%),brain (36.1%) and liver (20.6%). The objective response rate (complete or partial response) to first-line chemotherapy was 43.8%. The median age of patients was 65 years. The median BMI was 25.8, the median PNI1 was 41.3 and the median skeletal muscle area1 was 7.0. Median BMI2 was 23.5 and PNI2 was 41.1 and skeletal muscle area2 was 6.3. PNI was decreased in 51% and increased in 47.7% of patients. There is no statistically significant difference between survival and PNI change (p = 0.929). There is no statistically significant relationship between baseline skeletal muscle area and survival (p = 0.05). Conclusion: There was no significant correlation between PNI and survival. Although there was no significant relationship between skeletal muscle area and survival, a numerical difference was obtained.