PD1033 - COMBINED LOW APPENDICULAR AND RESPIRATORY MUSCLE MASS IS ASSOCIATED WITH REDUCED POSTOPERATIVE EXERCISE CAPACITY FOLLOWING LUNG CANCER SURGERY

PD1033

COMBINED LOW APPENDICULAR AND RESPIRATORY MUSCLE MASS IS ASSOCIATED WITH REDUCED POSTOPERATIVE EXERCISE CAPACITY FOLLOWING LUNG CANCER SURGERY

K. Shirado^1,*, T. Kido¹, Y. Chikaishi², S. Oka²

¹Rehabilitation, ²Chest Surgery, Aso Iizuka Hospital, Iizuka, Japan

Rationale: Preoperative skeletal muscle mass is associated with postoperative outcomes; however, its relationship with postoperative exercise capacity remains unclear. With the emerging concept of respiratory sarcopenia, which highlights the clinical impact of respiratory muscle loss and reduced strength, we hypothesized that combined low appendicular and respiratory muscle mass would be associated with reduced postoperative exercise capacity after lung resection.

Methods: This retrospective study included patients who underwent lobectomy for non-small cell lung cancer between April 2023 and September 2024. Appendicular skeletal muscle index (SMI) was assessed by bioelectrical impedance analysis, and intercostal (IMI) and pectoralis (PMI) muscle indices by preoperative computed tomography. SMI was classified according to the latest Asian Working Group for Sarcopenia criteria, while IMI and PMI were dichotomized by sex-specific medians. Combined low muscle mass was defined as low SMI with low IMI or low PMI. The primary outcome was the ratio of six-minute walk distance at discharge to baseline. Multivariable linear regression was performed, adjusting for age, sex, vital capacity, surgical approach, and length of stay.

Results: A total of 69 patients were analyzed (median age 75 years; 56.5% male). The median outcome was 89.9%. SMI, PMI, and IMI alone were not associated with the outcome, and SMI+PMI was not significant either. Combined low SMI and IMI was independently associated with a lower value (B = −10.42, p = 0.023). 

Conclusion: Combined low appendicular and intercostal muscle indices, but not single muscle indices, were associated with reduced postoperative exercise capacity. Integrated assessment, including respiratory muscle mass, may improve preoperative risk stratification in lung cancer surgery.

Disclosure of Interest: None declared