Effect of adipose tissue volume on prognosis in patients with non-small cell lung cancer

Abstract

Objective: This study evaluated the relationship between adipose tissue volume and survival in patients with non-small cell lung cancer (NSCLC). Methods: We retrospectively included 171 NSCLC patients who underwent staging F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and subsequent curative surgical resection or definite chemoradiotherapy. Maximum standardized uptake value (SUV) of lung cancer normalized by lean body mass (SULmax) and volume and mean SUV of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were derived from PET/CT images. The relationships of volume and mean SUV of SAT and VAT with survival were assessed. Results: Of the 171 patients, 79 (46.2%) experienced disease progression and 61 patients (35.7%) died during follow-up. SULmax had significant negative correlation with SAT volume (p = 0.003), but not with VAT volume and mean SUV of SAT and VAT (p > 0.05). On multivariate analysis, advanced TNM stage and high SULmax were significantly related with worse progression-free survival (PFS) and high SAT volume was significantly associated with better PFS (p < 0.05). Patient subgroups of high SULmax (> 4.6) and low SAT volume (< 75 cm(3)) had the highest disease progression rate of 61.7%, while other patient subgroups showed rates between 21.1 and 33.3%. SAT volume was significantly related with overall survival on univariate analysis, but failed to show significance on multivariate analysis. Only TNM stage was an independent prognostic factor for overall survival. Conclusion: SAT volume had significant favorable effect on PFS in patients with NSCLC.