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Body Composition in Resectable Non-Small Cell Lung Cancer Patients With Preoperative Sarcopenia: A Propensity-Matched
Zhu-Zhu Wang1,2, Jin-Yu He2, Rui-Feng Tang2
1The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Journal of Cachexia, Sarcopenia and Muscle
|February 13, 2026
Summary
Sarcopenia in early-stage non-small cell lung cancer (NSCLC) involves widespread body composition depletion, not just muscle loss. Bioelectrical impedance analysis (BIA) reveals distinct sex-specific patterns and aids in assessing these complex changes.
Area of Science:
- Oncology
- Gerontology
- Nutritional Science
Background:
- Sarcopenia is a known prognostic factor in early-stage non-small cell lung cancer (NSCLC).
- Comprehensive body composition (BC) alterations in NSCLC patients with sarcopenia are not well understood.
- This study investigates BC changes in early-stage NSCLC patients with preoperative sarcopenia, focusing on sex differences.
Purpose of the Study:
- To delineate body composition (BC) alterations in early-stage NSCLC patients with preoperative sarcopenia using bioelectrical impedance analysis (BIA).
- To identify sex-specific disparities in BC changes associated with sarcopenia.
- To determine independent BC factors associated with sarcopenia in this population.
Main Methods:
- A case-control study involving 460 patients with Stage I-II NSCLC.
- Sarcopenia diagnosed preoperatively using Asian Working Group for Sarcopenia 2019 criteria.
- Multifrequency BIA performed pre-surgery, followed by propensity score matching (PSM) and multivariable logistic regressions.
Main Results:
- Matched analysis revealed sarcopenic patients had significantly lower body fat mass, body cell mass, bone mineral content, and basal metabolic rate compared to non-sarcopenic patients.
- Distinct sex-specific phenotypes: females showed coordinated muscle, fat, and mineral depletion, while males had isolated muscle loss.
- Appendicular skeletal muscle mass, body fat mass, and basal metabolic rate were independent factors associated with sarcopenia; sex modified associations for several BC parameters.
Conclusions:
- Preoperative sarcopenia in early-stage NSCLC is a multicompartment depletion syndrome with cellular and metabolic impairments.
- Distinct sex-specific phenotypes of sarcopenia exist in NSCLC patients.
- BIA is a valuable tool for multidimensional BC assessment, supporting the development of sex-tailored prehabilitation strategies.
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