ArticleBMC pulmonary medicine2026
Impact of combined skeletal muscle index, subcutaneous fat index, and visceral fat index on prognosis in non-metastatic non-small cell lung cancer.
Article in BMC pulmonary medicine, 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
backgroundThe 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.
methodsConsecutive 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).
resultsA 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).
conclusionPreoperative 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.
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