Department of Orthopedics and Physical Rehabilitation; School of Medicine; Department of Radiation Oncology; Department of Radiology; Department of Surgery
Neoplasms | Oncology | Orthopedics | Pathological Conditions, Signs and Symptoms | Radiation Medicine | Radiology | Rehabilitation and Therapy
Introduction: Fifteen to seventy percent of cancer patients demonstrate sarcopenia.1-6,[i],[ii],[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii],[xiii] Analysis of iliopsoas cross-sectional area, a non-invasive surrogate measure for sarcopenia in patients with cancer has been associated with survival.[xiv],[xv],[xvi],[xvii] The pectoralis muscle may be a more accessible target for measuring sarcopenia in lung cancer patients,[xviii] but it is not known if it this correlates with iliopsoas cross-sectional area. Since measurements vary, it is most accurate to use internal controls. We attempted to examine the cross-sectional area of the two muscles and any change over the treatment period.
Methods: Charts were reviewed in 44 subjects who underwent surgical treatment of lung cancer. Available imaging at pre-treatment, 6 months, and 12 months was reviewed for the cross-sectional area of the pectoralis and the iliopsoas. The cross-sectional area of the pectoralis and the iliopsoas were measured manually at diagnosis by two different researchers, and the pectoralis was measured at 6 months and 12 months in subjects who were treated for lung cancer. Follow-up iliopsoas data was not available.
Results: Of the 44 subjects, 13 had a complete set of imaging. The mean age was 66 years old and the mean BMI was 28.72. There were 8 females and 5 males. 12 out of 13 were Caucasian. 12 out of 13 were stage T1 or T2. 12 out of 13 had undergone lobectomy. 10 out of the 13 were at ECOG performance status grade 0 at diagnosis. 4 out of 13 had postoperative events. The mean iliopsoas area at diagnosis was 8.17cm2. The mean pectoralis area at diagnosis was 14.5 cm2. The mean pectoralis area at 6 months was 13.9 cm2. The mean pectoralis area at 12 months was 14.5cm2. 8 out of 13 subjects had a decrease in mean pectoralis area at 6 months and 6 subjects had a decrease at 12 months.
Conclusion: There was no significant decrease in cross-sectional area of the pectoralis over the lung cancer treatment period. This could be because of the initial high performance status of our sample, the small size, or sarcopenia occurs comorbidly with presentation.
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lung cancer, sarcopenia, pectoralis, iliopsoas, imaging
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Prehabilitation World Congress 2019
Baima J, Schipani ES, Kamran W, Varlotto JM, McIntosh LJ, Uy K, Emmerick I, Most MJ. (2019). Sarcopenia in lung cancer: Could chest imaging help?. Orthopedics and Physical Rehabilitation Publications and Presentations. Retrieved from https://escholarship.umassmed.edu/ortho_pp/191