Increased skeletal muscle loss as a predictor of recurrence in postoperative lung cancer patients.

Authors

Zeynep Nilufer Tekin, Zeynep Bilgi

Published in

Irish journal of medical science. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Skeletal muscle loss and sarcopenia are associated with adverse outcomes in patients with non-small cell lung cancer (NSCLC). However, the relationship between longitudinal postoperative changes in CT-derived skeletal muscle mass and cancer recurrence remains insufficiently explored.
To evaluate longitudinal changes in CT-derived skeletal muscle mass at the T4 vertebral level after curative-intent resection for NSCLC and investigate their association with cancer recurrence.
Patients who underwent anatomic or non-anatomic lung resection for NSCLC between January 2016 and December 2019 and were followed at the same institution were included. Preoperative and recurrence or last follow-up CT images were evaluated for skeletal muscle mass at the T4 level using the open-source software 3D Slicer.
Sixty-three patients were evaluated, including 44 with recurrence and 19 without recurrence. Mean time to recurrence was 21.1 ± 17.6 months, and mean follow-up in controls was 41.5 ± 10.0 months. Initial and recurrence/last follow-up skeletal muscle mass measurements were comparable between groups. However, mean monthly total skeletal muscle mass loss was significantly greater in patients with recurrence than in controls (135.68 ± 285.52 vs. 16.31 ± 31.53, respectively; p = 0.015). A monthly back muscle mass loss cut-off of ≥ 250.29 showed 79.5% sensitivity, 84.2% specificity, and an area under the curve of 0.840 for detecting recurrence. Loss above this cut-off was independently associated with recurrence (odds ratio = 12.583; 95% confidence interval: 2.41-65.66).
Accelerated postoperative skeletal muscle loss was associated with NSCLC recurrence. Serial T4-level muscle assessment on routine surveillance CT may provide a practical supplementary marker for identifying patients at increased risk of recurrence.

PMID:
42862449
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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