ArticleFrontiers in oncology2026
The role of L3 skeletal muscle index in the diagnosis and prognosis prediction of sarcopenia and malnutrition in cancer patients.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study investigated the validity of the third lumbar skeletal muscle index (L3-SMI) as a marker of reduced muscle mass (RMM) in hospitalized cancer patients. It further evaluated the diagnostic accuracy of L3-SMI for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and examined the relationship between L3-SMI and long-term survival in cancer patients. Methods: A retrospective analysis was conducted between April 2014 and November 2018 at Daping Hospital, affiliated with Army Medical University. A total of 284 cancer patients were included. Analytical methods used in this study comprised receiver operating characteristic (ROC) curve analysis, Kaplan-Meier survival analysis, Cox proportional hazards regression models, time-dependent ROC curves, and kappa statistics. Results: Using the GLIM criteria with L3-SMI, 99 patients (34.86%) were diagnosed with malnutrition. Cox regression analysis revealed that patients diagnosed with malnutrition based on L3-SMI had the highest hazard ratio (HR = 1.954, 95% CI = 1.291-2.958) for mortality. Kaplan-Meier survival analysis showed that malnourished patients had significantly poorer overall survival. The agreement between GLIM-SMI and the Patient-Generated Subjective Global Assessment (PG-SGA) in diagnosing malnutrition was moderate (Kappa = 0.550). Time-dependent ROC curve analysis demonstrated that the area under the curve (AUC) for GLIM-SMI was 0.617, 0.578, and 0.578 at 1-year, 3-year, and 5-year survival monitoring, respectively. Conclusion: The L3-SMI may be a useful alternative indicator for reduced muscle mass in hospitalized cancer patients. GLIM evaluated by incorporation of L3-SMI is independently associated with long-term survival outcomes in this patient population. The prognostic significance of GLIM-L3-SMI requires further validation in other cohorts with large sample size.
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