Lee Gazourian1, Chantal S Durgana2, Devon Huntley3, Giulia S Rizzo4, William B Thedinger3, Shawn M Regis5, Lori Lyn Price6,7, Elizabeth J Pagura8, Carla Lamb8, Kimberly Rieger-Christ9, Carey C Thomson10,11, Cristina F Stefanescu12, Ava Sanayei3, William P Long3, Andrea B McKee5, George R Washko13,14, Raul San José Estépar14,15, Christoph Wald16, Timothy N Liesching8, Brady J McKee16. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA. Lee.Gazourian@lahey.org. 2. Tufts University, Medford, USA. 3. Tufts University School of Medicine, Boston, USA. 4. UMass Memorial Medical Center, Worcester, USA. 5. Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, USA. 6. Tufts Clinical and Translational Science Institute, Tufts University, Boston, USA. 7. Institute of Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, USA. 8. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA. 9. Cancer Research, Sophia Gordon Cancer Center, Lahey Hospital & Medical Center, Burlington, USA. 10. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mount Auburn Hospital, Cambridge, USA. 11. Harvard Medical School, Boston, USA. 12. Floating Hospital for Children, Tufts Medical Center, Boston, USA. 13. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, USA. 14. Applied Chest Imaging Laboratory, Brigham and Women's Hospital, Boston, USA. 15. Department of Radiology, Brigham and Women's Hospital, Boston, USA. 16. Department of Radiology, Lahey Hospital & Medical Center, Burlington, USA.
Abstract
BACKGROUND: Studies have demonstrated an inverse relationship between body mass index (BMI) and the risk of developing lung cancer. We conducted a retrospective cohort study evaluating baseline quantitative computed tomography (CT) measurements of body composition, specifically muscle and fat area in a large CT lung screening cohort (CTLS). We hypothesized that quantitative measurements of baseline body composition may aid in risk stratification for lung cancer. METHODS: Patients who underwent baseline CTLS between January 1st, 2012 and September 30th, 2014 and who had an in-network primary care physician were included. All patients met NCCN Guidelines eligibility criteria for CTLS. Quantitative measurements of pectoralis muscle area (PMA) and subcutaneous fat area (SFA) were performed on a single axial slice of the CT above the aortic arch with the Chest Imaging Platform Workstation software. Cox multivariable proportional hazards model for cancer was adjusted for variables with a univariate p < 0.2. Data were dichotomized by sex and then combined to account for baseline differences between sexes. RESULTS: One thousand six hundred and ninety six patients were included in this study. A total of 79 (4.7%) patients developed lung cancer. There was an association between the 25th percentile of PMA and the development of lung cancer [HR 1.71 (1.07, 2.75), p < 0.025] after adjusting for age, BMI, qualitative emphysema, qualitative coronary artery calcification, and baseline Lung-RADS® score. CONCLUSIONS: Quantitative assessment of PMA on baseline CTLS was associated with the development of lung cancer. Quantitative PMA has the potential to be incorporated as a variable in future lung cancer risk models.
BACKGROUND: Studies have demonstrated an inverse relationship between body mass index (BMI) and the risk of developing lung cancer. We conducted a retrospective cohort study evaluating baseline quantitative computed tomography (CT) measurements of body composition, specifically muscle and fat area in a large CT lung screening cohort (CTLS). We hypothesized that quantitative measurements of baseline body composition may aid in risk stratification for lung cancer. METHODS: Patients who underwent baseline CTLS between January 1st, 2012 and September 30th, 2014 and who had an in-network primary care physician were included. All patients met NCCN Guidelines eligibility criteria for CTLS. Quantitative measurements of pectoralis muscle area (PMA) and subcutaneous fat area (SFA) were performed on a single axial slice of the CT above the aortic arch with the Chest Imaging Platform Workstation software. Cox multivariable proportional hazards model for cancer was adjusted for variables with a univariate p < 0.2. Data were dichotomized by sex and then combined to account for baseline differences between sexes. RESULTS: One thousand six hundred and ninety six patients were included in this study. A total of 79 (4.7%) patients developed lung cancer. There was an association between the 25th percentile of PMA and the development of lung cancer [HR 1.71 (1.07, 2.75), p < 0.025] after adjusting for age, BMI, qualitative emphysema, qualitative coronary artery calcification, and baseline Lung-RADS® score. CONCLUSIONS: Quantitative assessment of PMA on baseline CTLS was associated with the development of lung cancer. Quantitative PMA has the potential to be incorporated as a variable in future lung cancer risk models.
Entities:
Keywords:
Lung cancer; Lung cancer screening; Quantitive pectoralis muscle area
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