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Background <p>Reduced physiological reserve and overall systemic state are important determinants of prognosis in non-small cell lung cancer (NSCLC). The predicted skeletal muscle index (pSMI), calculated from serum creatinine to cystatin C ratio, age, body weight, and hemoglobin, has been proposed as a laboratory-based surrogate of skeletal muscle mass; however, its prognostic value in surgically treated NSCLC remains unclear.</p> Methods <p>We retrospectively analyzed 199 patients who underwent curative-intent resection for NSCLC between 2019 and 2023. Patients were classified into low and high pSMI groups using previously reported sex-specific cutoff values. Overall survival (OS) and relapse-free survival (RFS) were evaluated using Kaplan–Meier methods and multivariable Cox proportional hazards models. The prognostic performance of pSMI was compared with body mass index (BMI), prognostic nutritional index (PNI), and CT-derived SMI.</p> Results <p>pSMI correlated with CT-derived SMI and BMI, and low pSMI was more frequent in patients with larger tumors and vascular invasion. Sixty-four patients (32.2%) were classified into the low pSMI group and 135 (67.8%) into the high pSMI group. Low pSMI was associated with worse OS and RFS. After adjustment for age, pathological stage, vascular invasion, and either BMI, PNI, or CT-derived SMI, low pSMI remained independently associated with worse RFS (adjusted hazard ratio 2.48–2.87, all <i>p</i> &lt; 0.05). In contrast, BMI, PNI, and CT-derived SMI were not independently associated with RFS.</p> Conclusions <p>Low pSMI was independently associated with worse RFS after resection for NSCLC. pSMI may capture aspects of systemic vulnerability and facilitate preoperative risk stratification in patients undergoing surgery for NSCLC.</p>

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Prognostic significance of predicted skeletal muscle index after curative-intent resection for non-small cell lung cancer

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Kenji Kameyama,
  • Satoru Okada,
  • Machiko Nishi,
  • Tatsuo Furuya,
  • Chiaki Nakazono,
  • Atsuki Uchibori,
  • Tomoki Nishimura,
  • Rintaro Kawanishi,
  • Masayoshi Inoue,
  • Tsunehiro Ii

摘要

Background

Reduced physiological reserve and overall systemic state are important determinants of prognosis in non-small cell lung cancer (NSCLC). The predicted skeletal muscle index (pSMI), calculated from serum creatinine to cystatin C ratio, age, body weight, and hemoglobin, has been proposed as a laboratory-based surrogate of skeletal muscle mass; however, its prognostic value in surgically treated NSCLC remains unclear.

Methods

We retrospectively analyzed 199 patients who underwent curative-intent resection for NSCLC between 2019 and 2023. Patients were classified into low and high pSMI groups using previously reported sex-specific cutoff values. Overall survival (OS) and relapse-free survival (RFS) were evaluated using Kaplan–Meier methods and multivariable Cox proportional hazards models. The prognostic performance of pSMI was compared with body mass index (BMI), prognostic nutritional index (PNI), and CT-derived SMI.

Results

pSMI correlated with CT-derived SMI and BMI, and low pSMI was more frequent in patients with larger tumors and vascular invasion. Sixty-four patients (32.2%) were classified into the low pSMI group and 135 (67.8%) into the high pSMI group. Low pSMI was associated with worse OS and RFS. After adjustment for age, pathological stage, vascular invasion, and either BMI, PNI, or CT-derived SMI, low pSMI remained independently associated with worse RFS (adjusted hazard ratio 2.48–2.87, all p < 0.05). In contrast, BMI, PNI, and CT-derived SMI were not independently associated with RFS.

Conclusions

Low pSMI was independently associated with worse RFS after resection for NSCLC. pSMI may capture aspects of systemic vulnerability and facilitate preoperative risk stratification in patients undergoing surgery for NSCLC.