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Updated: May 5, 2026
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
Association between postoperative iliopsoas muscle cross-sectional area changes and prognosis in elderly patients
Shoko Kubota1,2,3, Joji Samejima1, Makoto Tada1
1Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Background:
The cross-sectional area (CSA) of the iliopsoas muscle on computed tomography is associated with sarcopenia, but its perioperative changes and prognostic significance in lung cancer remain unclear. This study aimed to clarify postoperative changes in the iliopsoas CSA and their prognostic correlation in the perioperative period of lung cancer.
Methods:
We analyzed 270 patients with lung cancer age ≥70 years who underwent lobectomy between January 2016 and December 2020. Iliopsoas CSA at the L3 vertebral level was measured preoperatively and at 6 and 12 months postoperatively and analyzed with ImageJ software. Patients were grouped based on whether their CSA decreased or increased between 6 months and 12 months postoperatively. Recurrence-free survival (RFS) and overall survival (OS) were compared between groups.
Results:
Compared with preoperatively, the iliopsoas CSA was decreased significantly at 6 months (23.2 mm2; P < .01) and 12 months (15.5 mm2; P = .03). Patients in the decreasing CSA were older (P = .02), more often male (P = .02), and had poorer lung function (P = .04). Decreased CSA was linked to poorer 5-year RFS (P = .07) and significantly worse OS (P = .04). The multivariate analysis revealed that a decrease in iliopsoas muscle CSA between 6 months and 12 months postoperatively was an independent poor prognostic factor for RFS (P < .01) and OS (P = .05).
Conclusions:
In elderly patients with primary lung cancer, decreased iliopsoas CSA from 6 months to 12 months postoperatively was at least an independent poor prognostic factor for OS.
