Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study
Abstract Background Thoracic muscles contribute to respiration, is a crucial indicator for assessing functional recovery following lung resection. However, there is a lack of research on the long-term prognostic value of pectoralis muscle. Methods Consecutive patients who underwent curative-intent r...
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BMC
2025-08-01
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| Series: | BMC Medical Imaging |
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| Online Access: | https://doi.org/10.1186/s12880-025-01873-0 |
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| author | Zhihui Shi Lin Wu Dengke Jiang Ruiling Yang Rui Liao Lizhu Liu Ruimin You Yanli Li Xingxiang Dong Dafu Zhang Jing Wang Xuewen Zhang Xiaobo Chen Zhenhui Li |
| author_facet | Zhihui Shi Lin Wu Dengke Jiang Ruiling Yang Rui Liao Lizhu Liu Ruimin You Yanli Li Xingxiang Dong Dafu Zhang Jing Wang Xuewen Zhang Xiaobo Chen Zhenhui Li |
| author_sort | Zhihui Shi |
| collection | DOAJ |
| description | Abstract Background Thoracic muscles contribute to respiration, is a crucial indicator for assessing functional recovery following lung resection. However, there is a lack of research on the long-term prognostic value of pectoralis muscle. Methods Consecutive patients who underwent curative-intent resection for stage I to IIIA NSCLC between 2013 and 2018 at a cancer center were retrospectively identified. The Cox proportional hazard model was employed to analyze the correlation between pectoralis muscle index (PMI) and survival, with subgroup analyses conducted to explore potential heterogeneity among different subgroups. Finally, the relative influence of each parameter was compared using a gradient boosting model (GBM). Results A total of 2110 patients (median (IQR) age 59 (52, 66) years) were evaluated. Kaplan-Meier survival analysis showed that the recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) rate of patients in the high PMI group were higher than those in the low PMI group, all with P < 0.001. In the multivariable analysis, low PMI is still associated with shorter RFS (HR = 1.34, 95% CI: (1.10, 1.62), P = 0.004), DMFS (HR = 1.35, 95% CI: (1.11, 1.65), P = 0.003), lung MFS (HR = 1.47, 95% CI: (1.19, 1.81), P < 0.001) and bone MFS (HR = 1.38, 95% CI: (1.11, 1.73), P = 0.004). These associations were consistent in subgroup analysis of different gender, age, tumor stage, histologic type, and surgical approach group. Conclusions Low PMI is significantly associated with worse distant metastasis-free survival (DMFS) and recurrence-free survival (RFS) in non-small cell lung cancer (NSCLC) patients, supporting its utility in refining preoperative risk stratification. When CT imaging lacks L3-level coverage, PMI offers a viable alternative for assessing muscle quality. |
| format | Article |
| id | doaj-art-2c533394d5c24d7cacd8c3cb1c2470cd |
| institution | Kabale University |
| issn | 1471-2342 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Medical Imaging |
| spelling | doaj-art-2c533394d5c24d7cacd8c3cb1c2470cd2025-08-24T11:57:44ZengBMCBMC Medical Imaging1471-23422025-08-0125111210.1186/s12880-025-01873-0Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective studyZhihui Shi0Lin Wu1Dengke Jiang2Ruiling Yang3Rui Liao4Lizhu Liu5Ruimin You6Yanli Li7Xingxiang Dong8Dafu Zhang9Jing Wang10Xuewen Zhang11Xiaobo Chen12Zhenhui Li13Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Second Affiliated Hospital of Hunan University of Chinese MedicineDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterUniversity Library, Kunming Medical UniversityDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterDepartment of Radiology, Dali Bai Autonomous Prefecture Chinese Medicine HospitalDepartment of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical UniversityDepartment of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer CenterAbstract Background Thoracic muscles contribute to respiration, is a crucial indicator for assessing functional recovery following lung resection. However, there is a lack of research on the long-term prognostic value of pectoralis muscle. Methods Consecutive patients who underwent curative-intent resection for stage I to IIIA NSCLC between 2013 and 2018 at a cancer center were retrospectively identified. The Cox proportional hazard model was employed to analyze the correlation between pectoralis muscle index (PMI) and survival, with subgroup analyses conducted to explore potential heterogeneity among different subgroups. Finally, the relative influence of each parameter was compared using a gradient boosting model (GBM). Results A total of 2110 patients (median (IQR) age 59 (52, 66) years) were evaluated. Kaplan-Meier survival analysis showed that the recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) rate of patients in the high PMI group were higher than those in the low PMI group, all with P < 0.001. In the multivariable analysis, low PMI is still associated with shorter RFS (HR = 1.34, 95% CI: (1.10, 1.62), P = 0.004), DMFS (HR = 1.35, 95% CI: (1.11, 1.65), P = 0.003), lung MFS (HR = 1.47, 95% CI: (1.19, 1.81), P < 0.001) and bone MFS (HR = 1.38, 95% CI: (1.11, 1.73), P = 0.004). These associations were consistent in subgroup analysis of different gender, age, tumor stage, histologic type, and surgical approach group. Conclusions Low PMI is significantly associated with worse distant metastasis-free survival (DMFS) and recurrence-free survival (RFS) in non-small cell lung cancer (NSCLC) patients, supporting its utility in refining preoperative risk stratification. When CT imaging lacks L3-level coverage, PMI offers a viable alternative for assessing muscle quality.https://doi.org/10.1186/s12880-025-01873-0Non-small cell lung carcinomaPectoralis musclesBody compositionRecurrenceNeoplasm metastasis |
| spellingShingle | Zhihui Shi Lin Wu Dengke Jiang Ruiling Yang Rui Liao Lizhu Liu Ruimin You Yanli Li Xingxiang Dong Dafu Zhang Jing Wang Xuewen Zhang Xiaobo Chen Zhenhui Li Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study BMC Medical Imaging Non-small cell lung carcinoma Pectoralis muscles Body composition Recurrence Neoplasm metastasis |
| title | Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study |
| title_full | Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study |
| title_fullStr | Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study |
| title_full_unstemmed | Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study |
| title_short | Preoperative pectoralis muscle index predicts distant metastasis-free survival in non-small cell lung cancer patients: a retrospective study |
| title_sort | preoperative pectoralis muscle index predicts distant metastasis free survival in non small cell lung cancer patients a retrospective study |
| topic | Non-small cell lung carcinoma Pectoralis muscles Body composition Recurrence Neoplasm metastasis |
| url | https://doi.org/10.1186/s12880-025-01873-0 |
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