ArticleInternational journal of clinical oncology2026
Prognostic significance of predicted skeletal muscle index after curative-intent resection for non-small cell lung cancer.
Article in International journal of clinical 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
backgroundReduced physiological reserve and overall systemic state are important determinants of prognosis in non-small cell lung cancer (NSCLC). The predicted skeletal muscle index (pSMI), calculated from serum creatinine to cystatin C ratio, age, body weight, and hemoglobin, has been proposed as a laboratory-based surrogate of skeletal muscle mass; however, its prognostic value in surgically treated NSCLC remains unclear.
methodsWe retrospectively analyzed 199 patients who underwent curative-intent resection for NSCLC between 2019 and 2023. Patients were classified into low and high pSMI groups using previously reported sex-specific cutoff values. Overall survival (OS) and relapse-free survival (RFS) were evaluated using Kaplan-Meier methods and multivariable Cox proportional hazards models. The prognostic performance of pSMI was compared with body mass index (BMI), prognostic nutritional index (PNI), and CT-derived SMI.
resultspSMI correlated with CT-derived SMI and BMI, and low pSMI was more frequent in patients with larger tumors and vascular invasion. Sixty-four patients (32.2%) were classified into the low pSMI group and 135 (67.8%) into the high pSMI group. Low pSMI was associated with worse OS and RFS. After adjustment for age, pathological stage, vascular invasion, and either BMI, PNI, or CT-derived SMI, low pSMI remained independently associated with worse RFS (adjusted hazard ratio 2.48-2.87, all p < 0.05). In contrast, BMI, PNI, and CT-derived SMI were not independently associated with RFS.
conclusionsLow pSMI was independently associated with worse RFS after resection for NSCLC. pSMI may capture aspects of systemic vulnerability and facilitate preoperative risk stratification in patients undergoing surgery for NSCLC.
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