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Background <p>The combined prognostic role of skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) in non-metastatic non-small cell lung cancer (NSCLC) remains unclear.</p> Methods <p>Consecutive non-metastatic NSCLC patients who underwent radical pulmonary resection at Yunnan Cancer Hospital from January 2013 to December 2018 were analyzed. Preoperative CT-derived SMI, SFI, and VFI at the third lumbar vertebra level (L3) were stratified into sex-specific high and low groups. A composite index was created based on the count of low-value measures among the three indices. Cox regression evaluated associations with overall survival (OS) and relapse-free survival (RFS).</p> Results <p>A total of 1661 patients (mean age 58.9 ± 9.5 years; 911 men [54.8%] and 750 women [45.2%]) were enrolled, with a median follow-up of 73.97 months (95% CI: 72.80–75.10). Low SMI (HR = 1.49, 95% CI: 1.16–1.92, <i>p</i> = 0.002), low SFI (HR = 1.54, 95% CI: 1.22–1.94, <i>p</i> &lt; 0.001), and low VFI (HR = 1.69, 95% CI: 1.32–2.17, <i>p</i> &lt; 0.001) were associated with poorer OS. The composite index demonstrated poorer OS with an increasing number of low indices (SMI, SFI, and VFI) (<i>p</i> for trend &lt; 0.001): one-low (HR = 1.50, 95% CI: 1.16–1.94, <i>p</i> = 0.002), two-low (HR = 1.71, 95% CI: 1.29–2.28, <i>p</i> &lt; 0.001), and all-low (HR = 2.99, 95% CI: 1.89–4.71, <i>p</i> &lt; 0.001). Similar trend occurred for RFS (all <i>p</i> &lt; 0.05).</p> Conclusion <p>Preoperative SMI, SFI, and VFI were independently associated with prognosis in patients with NSCLC, and a composite index integrating these measures may provide valuable complementary information for risk stratification.</p>

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Impact of combined skeletal muscle index, subcutaneous fat index, and visceral fat index on prognosis in non-metastatic non-small cell lung cancer

  • 期刊论文

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  • 发表日期：

    2026年3月12日

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  • Fahui Chen,
  • Zhihui Shi,
  • Hua Bai,
  • Hongtao Lei,
  • Hongjiang Pu,
  • Yang Yang,
  • Yongmei Wu,
  • Ying Zhao,
  • Xin Ning,
  • Guanghong Yan,
  • Mengmei Liu,
  • Yani Li,
  • Sifan Duan,
  • Hanqun Liu,
  • Chang Shu,
  • Lu Lu,
  • Wenjing Xia,
  • Xuewen Zhang,
  • Zhenhui Li,
  • Dingyun You

摘要

Background

The combined prognostic role of skeletal muscle index (SMI), subcutaneous fat index (SFI), and visceral fat index (VFI) in non-metastatic non-small cell lung cancer (NSCLC) remains unclear.

Methods

Consecutive non-metastatic NSCLC patients who underwent radical pulmonary resection at Yunnan Cancer Hospital from January 2013 to December 2018 were analyzed. Preoperative CT-derived SMI, SFI, and VFI at the third lumbar vertebra level (L3) were stratified into sex-specific high and low groups. A composite index was created based on the count of low-value measures among the three indices. Cox regression evaluated associations with overall survival (OS) and relapse-free survival (RFS).

Results

A total of 1661 patients (mean age 58.9 ± 9.5 years; 911 men [54.8%] and 750 women [45.2%]) were enrolled, with a median follow-up of 73.97 months (95% CI: 72.80–75.10). Low SMI (HR = 1.49, 95% CI: 1.16–1.92, p = 0.002), low SFI (HR = 1.54, 95% CI: 1.22–1.94, p < 0.001), and low VFI (HR = 1.69, 95% CI: 1.32–2.17, p < 0.001) were associated with poorer OS. The composite index demonstrated poorer OS with an increasing number of low indices (SMI, SFI, and VFI) (p for trend < 0.001): one-low (HR = 1.50, 95% CI: 1.16–1.94, p = 0.002), two-low (HR = 1.71, 95% CI: 1.29–2.28, p < 0.001), and all-low (HR = 2.99, 95% CI: 1.89–4.71, p < 0.001). Similar trend occurred for RFS (all p < 0.05).

Conclusion

Preoperative SMI, SFI, and VFI were independently associated with prognosis in patients with NSCLC, and a composite index integrating these measures may provide valuable complementary information for risk stratification.