ArticleAnnals of surgical oncology2026
Skeletal Muscle Gauge as a Prognosticator of Survival in Resected Early-Stage Non-small Cell Lung Cancer.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Prognostic role of preoperative skeletal muscle mass index in surgical lung cancer patients: a systematic review with meta-analysis.Journal of thoracic disease · 2026Article
- Sex-stratified prognostic value of low skeletal muscle index in advanced non-small cell lung Cancer: a retrospective cohort study.Frontiers in nutrition · 2026Article
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Authors and funding
9 authors.
Funding
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Abstract
backgroundSarcopenia has emerged as a prognostic biomarker in lung cancer, yet the optimal radiological metric for its assessment remains debated. Skeletal Muscle Gauge (SMG), a composite of muscle volume and density, may offer superior prognostic utility compared with individual measures. PATIENTS AND
methodsWe retrospectively analyzed 343 patients who underwent lung resection for clinical stage I-IIB NSCLC between 2010 and 2021 and had a preoperative positron emission tomography (PET) scan. Volumetric body composition metrics, skeletal muscle index, skeletal muscle area, skeletal muscle density (SMD), and SMG were derived from automated segmentation using PET scans followed by normalization. Associations with overall survival was assessed using Cox proportional hazards analyses. Predictive accuracy was evaluated using the concordance index. Optimal SMG cutoff was determined by maximally selected rank statistics.
resultsSMG and SMD were independently associated with overall survival after adjustment for clinical and tumor characteristics. SMG and SMD demonstrated the highest prognostic accuracy (C-index 0.743 and 0.710, respectively). No linear relationship was observed between skeletal muscle metrics and BMI, underscoring the limitation of BMI in detecting sarcopenia. SMG values < 87,816 AU were associated with significantly worse survival in both sexes (HR 2.34, 95% CI 1.48-3.69; p < 0.001).
conclusionsSMG outperforms individual skeletal muscle indices in predicting overall survival following lung resection for early-stage NSCLC. These findings support the clinical utility of this composite measure for assessing cancer associated sarcopenia and advocate for the integration of automated body composition analysis into preoperative evaluation.
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