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Body composition analysis in metastatic non-small-cell lung cancer : depicting sarcopenia in Portuguese tertiary care

datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorMendes, José Leão
dc.contributor.authorFerreira, Rita Quaresma
dc.contributor.authorMata, Inês
dc.contributor.authorBarreira, João Vasco
dc.contributor.authorRodrigues, Ysel Chiara
dc.contributor.authorDias, David Silva
dc.contributor.authorCapelas, Manuel Luís
dc.contributor.authorMäkitie, Antti
dc.contributor.authorGuerreiro, Inês
dc.contributor.authorPimenta, Nuno M.
dc.contributor.authorRavasco, Paula
dc.date.accessioned2026-04-28T15:03:57Z
dc.date.available2026-04-28T15:03:57Z
dc.date.issued2025-02
dc.description.abstractBackground/Objectives: Sarcopenia is an emergent prognostic biomarker in clinical oncology. Albeit increasingly defined through skeletal muscle index (SMI) thresholding, the literature cut-offs fail to discern heterogeneous baseline muscularity across populations. This study assesses the prognostic impact of using cohort-specific SMI thresholds in a Portuguese metastatic non-small-cell lung cancer (mNSCLC) cohort. Methods: Retrospective study including mNSCLC patients treated between January 2017 and December 2022. ImageJ v1.54 g was used to assess cross-sectional CT imaging at the third lumbar vertebra (L3) and calculate L3SMI. Sarcopenia was defined both according to Prado et al. and L3SMI thresholds derived from receiver operating characteristic analysis. Overall survival (OS) was the primary endpoint. Secondary endpoints included first-line (1L) progression-free survival (PFS) and sarcopenia subgroup analysis regarding body mass index impact on OS. Results: The initial cohort included 197 patients. Mean age was 65 years (±11.31). Most tumors were adenocarcinomas (n = 165) and presented with metastasis (n = 154). SMI was evaluable in 184 patients: cohort-specific thresholds (<49.96 cm2/m2 for men; <34.02 cm2/m2 for women) yielded 46.74% sarcopenic patients (n = 86) versus 66.30% (n = 122) per the literature definition. Cohort-specific thresholds predicted both OS (12.75 versus 21.13 months, hazard ratio [HR] 1.654, p = 0.002) and PFS (7.92 versus 9.56 months, HR 1.503, p = 0.01). Among sarcopenic patients, overweight (HR 0.417, p = 0.01) and obesity (HR 2.723, p = 0.039) had contrasting impacts on OS. Conclusions: Amid reclassification of nearly one-fifth of the cohort, cohort-specific thresholds improved sarcopenia prognostication in mNSCLC. Homogeneity regarding both cancer treatment setting and ethnicity could be key to defining sarcopenia based on SMI.eng
dc.identifier.citationLeão Mendes J, Ferreira RQ, Mata I, Vasco Barreira J, Rodrigues YC, Silva Dias D, Capelas ML, Mäkitie A, Guerreiro I, Pimenta NM, et al. Body Composition Analysis in Metastatic Non-Small-Cell Lung Cancer: Depicting Sarcopenia in Portuguese Tertiary Care. Cancers. 2025; 17(3):539. https://doi.org/10.3390/cancers17030539
dc.identifier.doi10.3390/cancers17030539
dc.identifier.issn2072-6694
dc.identifier.urihttp://hdl.handle.net/10400.26/62928
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://doi.org/10.3390/cancers17030539
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectnon-small-cell lung carcinoma
dc.subjectsarcopenia
dc.subjectbody composition
dc.subjectskeletal muscle index
dc.subjectprognosis
dc.titleBody composition analysis in metastatic non-small-cell lung cancer : depicting sarcopenia in Portuguese tertiary careeng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.issue3
oaire.citation.startPage539
oaire.citation.titleCancers
oaire.citation.volume17
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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