Till D Best1,2, Sarah F Mercaldo3, Darren S Bryan4, Jan Peter Marquardt1, Maria M Wrobel1,5, Christopher P Bridge6, Fabian M Troschel1,7, Cylen Javidan8, Jonathan H Chung9, Ashok Muniappan10, Sanjeev Bhalla8, Bryan F Meyers11, Mark K Ferguson4, Henning A Gaissert10, Florian J Fintelmann1. 1. Department of Radiology, Division of Thoracic Imaging and Intervention, Massachusetts General Hospital, Boston, Massachusetts. 2. Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 3. Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts. 4. Department of Surgery, University of Chicago, Chicago, Illinois. 5. Department of Radiology, Ludwig-Maximilians-University, München, Germany. 6. MGH and BWH Center for Clinical Data Science, Boston, Massachusetts. 7. Department of Radiation Therapy-Radiation Oncology, University Hospital Munster, Munster, Germany. 8. Mallinckrodt Institute of Radiology, Washington University in Saint Louis, Saint Louis, Missouri. 9. Departments of Medicine and Radiology, University of Chicago, Chicago, Illinois. 10. Department of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts. 11. Division of Cardiothoracic Surgery, Washington University in Saint Louis, Saint Louis, Missouri.
Abstract
OBJECTIVE: To investigate the impact of thoracic body composition on outcomes after lobectomy for lung cancer. SUMMARY AND BACKGROUND DATA: Preoperative identification of patients at risk for adverse outcomes permits treatment modification. The impact of body composition on lung resection outcomes has not been investigated in a multicenter setting. METHODS: A total of 958 consecutive patients undergoing lobectomy for lung cancer at 3 centers from 2014 to 2017 were retrospectively analyzed. Muscle and adipose tissue cross-sectional area at the fifth, eighth, and tenth thoracic vertebral body was quantified. Prospectively collected outcomes from a national database were abstracted to characterize the association between sums of muscle and adipose tissue and hospital length of stay (LOS), number of any postoperative complications, and number of respiratory postoperative complications using multivariate regression. A priori determined covariates were forced expiratory volume in 1 second and diffusion capacity of the lungs for carbon monoxide predicted, age, sex, body mass index, race, surgical approach, smoking status, Zubrod and American Society of Anesthesiologists scores. RESULTS: Mean patient age was 67 years, body mass index 27.4 kg/m2 and 65% had stage i disease. Sixty-three percent underwent minimally invasive lobectomy. Median LOS was 4 days and 34% of patients experienced complications. Muscle (using 30 cm2 increments) was an independent predictor of LOS (adjusted coefficient 0.972; P = 0.002), any postoperative complications (odds ratio 0.897; P = 0.007) and postoperative respiratory complications (odds ratio 0.860; P = 0.010). Sarcopenic obesity was also associated with LOS and adverse outcomes. CONCLUSIONS: Body composition on preoperative chest computed tomography is an independent predictor of LOS and postoperative complications after lobectomy for lung cancer.
OBJECTIVE: To investigate the impact of thoracic body composition on outcomes after lobectomy for lung cancer. SUMMARY AND BACKGROUND DATA: Preoperative identification of patients at risk for adverse outcomes permits treatment modification. The impact of body composition on lung resection outcomes has not been investigated in a multicenter setting. METHODS: A total of 958 consecutive patients undergoing lobectomy for lung cancer at 3 centers from 2014 to 2017 were retrospectively analyzed. Muscle and adipose tissue cross-sectional area at the fifth, eighth, and tenth thoracic vertebral body was quantified. Prospectively collected outcomes from a national database were abstracted to characterize the association between sums of muscle and adipose tissue and hospital length of stay (LOS), number of any postoperative complications, and number of respiratory postoperative complications using multivariate regression. A priori determined covariates were forced expiratory volume in 1 second and diffusion capacity of the lungs for carbon monoxide predicted, age, sex, body mass index, race, surgical approach, smoking status, Zubrod and American Society of Anesthesiologists scores. RESULTS: Mean patient age was 67 years, body mass index 27.4 kg/m2 and 65% had stage i disease. Sixty-three percent underwent minimally invasive lobectomy. Median LOS was 4 days and 34% of patients experienced complications. Muscle (using 30 cm2 increments) was an independent predictor of LOS (adjusted coefficient 0.972; P = 0.002), any postoperative complications (odds ratio 0.897; P = 0.007) and postoperative respiratory complications (odds ratio 0.860; P = 0.010). Sarcopenic obesity was also associated with LOS and adverse outcomes. CONCLUSIONS: Body composition on preoperative chest computed tomography is an independent predictor of LOS and postoperative complications after lobectomy for lung cancer.
Authors: Christopher P Bridge; Till D Best; Maria M Wrobel; J Peter Marquardt; Kirti Magudia; Cylen Javidan; Jonathan H Chung; Jayashree Kalpathy-Cramer; Katherine P Andriole; Florian J Fintelmann Journal: Radiol Artif Intell Date: 2022-01-05
Authors: Fabian M Troschel; Qianna Jin; Florian Eichhorn; Thomas Muley; Till D Best; Konstantin S Leppelmann; Chi-Fu Jeffrey Yang; Amelie S Troschel; Hauke Winter; Claus P Heußel; Henning A Gaissert; Florian J Fintelmann Journal: Cancer Med Date: 2021-08-19 Impact factor: 4.452
Authors: Stefania Rizzo; Francesco Petrella; Claudia Bardoni; Lorenzo Bramati; Andrea Cara; Shehab Mohamed; Davide Radice; Giorgio Raia; Filippo Del Grande; Lorenzo Spaggiari Journal: Front Oncol Date: 2022-03-15 Impact factor: 6.244
Authors: J Peter Marquardt; Eric J Roeland; Emily E Van Seventer; Till D Best; Nora K Horick; Ryan D Nipp; Florian J Fintelmann Journal: J Cachexia Sarcopenia Muscle Date: 2021-11-02 Impact factor: 12.910