Preoperative sarcopenia in early-stage NSCLC involves multicompartment depletion accompanied by cellular dysfunction and metabolic impairment, exhibiting distinct sex-specific phenotypes, with ASM, BFM, and BMR identified as independent factors associated with sarcopenia.
Key Findings
Results
Sarcopenic NSCLC patients exhibited systemic multicompartment depletion beyond reduced muscle mass across multiple body composition parameters.
After propensity score matching (1:4 ratio), 47 sarcopenic and 162 nonsarcopenic patients were compared.
Sarcopenic patients had lower body fat mass (BFM: 12.70 vs. 18.60 kg), body cell mass (BCM: 23.90 vs. 29.10 kg), bone mineral content (BMC: 2.22 vs. 2.52 kg), and basal metabolic rate (BMR: 1151.00 vs. 1340.50 kcal); all p < 0.001.
Sarcopenic patients also exhibited elevated extracellular water/intracellular water ratio (ECW/ICW: 0.64 vs. 0.63, p < 0.001), indicating cellular dysfunction.
Sarcopenia was diagnosed preoperatively based on Asian Working Group for Sarcopenia 2019 criteria; multifrequency BIA was performed within 48 h before surgery.
Results
Sarcopenic females demonstrated coordinated reductions in muscle, fat, and minerals, whereas sarcopenic males exhibited isolated muscle loss with preserved adiposity and minerals.
Sarcopenic females showed lower ASM (13.10 vs. 15.43 kg), BFM (11.20 vs. 19.20 kg), percent body fat (PBF: 25.41% vs. 32.88%), and BMC (2.05 vs. 2.26 kg); all p < 0.001.
In males, PBF was not significantly different between sarcopenic and nonsarcopenic patients (23.04% vs. 24.29%, p = 0.463), nor was BMC (2.64 vs. 2.80 kg, p = 0.141).
Sex significantly modified associations for waist-hip ratio, soft lean mass, FFM, and PBF (all p for interaction < 0.05).
Results
ASM, BFM, and BMR were independent body composition factors associated with sarcopenia in the fully adjusted multivariable logistic regression model.
ASM had the strongest association (OR = 0.03, 95% CI: 0.01–0.08).
BFM was independently associated with sarcopenia (OR = 0.81, 95% CI: 0.75–0.87).
BMR was also independently associated with sarcopenia (OR = 0.95, 95% CI: 0.94–0.97).
The model was fully adjusted and used propensity-matched data with balanced covariates including age, sex, height, physical activity, nutritional status, clinical stage, histology, extent of resection, and diabetes.
Methods
The prevalence of sarcopenia in the study cohort was assessed in 460 Stage I–II NSCLC patients enrolled from two tertiary hospitals in Anhui, China.
460 patients with Stage I–II NSCLC were initially enrolled.
After propensity score matching at a 1:4 ratio, 47 sarcopenic and 162 nonsarcopenic patients were well-matched.
Covariates balanced during PSM included age, sex, height, physical activity, nutritional status, clinical stage, histology, extent of resection, and diabetes.
This was a case-control study design.
Results
Sensitivity analyses based on sarcopenia severity supported the robustness of the primary body composition findings.
Sensitivity analyses were conducted stratifying by sarcopenia severity.
The primary findings regarding multicompartment depletion and sex-specific phenotypes were confirmed to be robust.
No specific numerical values for sensitivity analyses were reported in the abstract.
Conclusions
Bioelectrical impedance analysis (BIA) was identified as a practical tool for multidimensional body composition assessment in preoperative NSCLC patients.
Multifrequency BIA was performed within 48 h before surgery in all enrolled patients.
BIA enabled simultaneous assessment of ASM, BFM, BCM, BMC, BMR, ECW/ICW ratio, waist-hip ratio, soft lean mass, FFM, and PBF.
The authors concluded that BIA should be integrated into clinical workflows and used to develop sex-tailored prehabilitation strategies.
Wang Z, He J, Tang R, Zhang T, Luo L, Zhang Y, et al.. (2026). Body Composition in Resectable Non-Small Cell Lung Cancer Patients With Preoperative Sarcopenia: A Propensity-Matched Analysis.. Journal of cachexia, sarcopenia and muscle. https://doi.org/10.1002/jcsm.70230