Impact of pectoralis major muscle mass decrease after lobectomy on the prognosis of lung cancer

Area of Science:

• Thoracic surgery
• Surgical oncology
• Pulmonary medicine

Background:

• Low preoperative skeletal muscle mass is a known negative prognostic factor for non-small cell lung cancer (NSCLC).
• The clinical impact of skeletal muscle loss occurring after surgery for NSCLC is not well understood.
• This study examines the prognostic significance of postoperative pectoralis major muscle mass decline.

Purpose of the Study:

• To investigate the association between a decrease in pectoralis major muscle mass 12 months after lobectomy and long-term patient outcomes.
• To determine if postsurgical muscle loss is an independent predictor of survival in NSCLC patients.

Main Methods:

• Retrospective analysis of 460 patients with pathological stage I-II NSCLC who underwent lobectomy.
• Patients were stratified into two groups based on pectoralis major muscle mass change rate (cutoff: 0.94) at 12 months post-surgery.
• Long-term outcomes, including overall survival and incidence of chronic obstructive pulmonary disease (COPD), were assessed.

Main Results:

• A decrease in pectoralis major muscle mass was observed in 126 patients.
• The muscle mass decrease group had a higher incidence of COPD compared to the no-decrease group.
• Overall survival was significantly lower in patients with postsurgical muscle mass reduction (P < .001).
• Multivariable analysis identified pectoralis major muscle mass decrease as an independent negative prognostic factor for overall survival (HR, 1.05; P < .001).

Conclusions:

• A reduction in pectoralis major muscle mass after lobectomy is associated with poorer prognosis in NSCLC patients.
• Postsurgical skeletal muscle loss, specifically in the pectoralis major, is a significant indicator of long-term outcomes.