非小细胞肺癌（NSCLC）的外科切除术后，骨骼肌指数与围手术期结局改善相关。然而，不清楚这些指数是否能预测癌症的长期特异性结果。本分析纳入了我们医院2009年至2015年间接受肺叶切除术的NSCLC患者（N = 492）。采用术前CT扫描，利用sliceOmatic软件在L4上量化骨骼肌指数（SMI）。进行Cox比例模型分析总体生存（OS）和无复发生存（RFS）。所有患者的中位数SMI为45.7 cm2/m2（IQR, 40-53.8）。SMI与年龄呈负相关（R = -0.2；p < 0.05），与BMI呈正相关（R = 0.46；p < 0.05）。单变量Cox分析未发现与OS或RFS的关联。然而，针对SMI的多变量模型，包括年龄、性别、种族、吸烟状况、DLCO和FEV1（%预测值）、美国麻醉学会（ASA）评分、肿瘤组织学和分期，以及术后新辅助治疗，显示SMI改善了OS（HR = 0.97；p = 0.0005）和RFS（HR = 0.97；p = 0.01）。采用性别特定的中位数SMI作为截断点，较低的SMI与不良OS（HR = 1.65，p = 0.001）和RFS（HR = 1.47，p = 0.03）相关。SMI与NSCLC切除术后的结果改善相关。需要进一步研究以了解这一观察结果的生物学基础。本研究为设计和实施手术切除后康复试验提供了额外的合理性，以获得持久的肿瘤学益处。© 2023. BioMed Central Ltd., part of Springer Nature.

Skeletal muscle indices have been associated with improved peri-operative outcomes after surgical resection of non-small-cell lung cancer (NSCLC). However, it is unclear if these indices can predict long term cancer specific outcomes.NSCLC patients undergoing lobectomy at our institute between 2009-2015 were included in this analysis (N = 492). Preoperative CT scans were used to quantify skeletal muscle index (SMI) at L4 using sliceOmatic software. Cox proportional modelling was performed for overall (OS) and recurrence free survival (RFS).For all patients, median SMI was 45.7 cm2/m2 (IQR, 40-53.8). SMI was negatively associated with age (R = -0.2; p < 0.05) and positively associated with BMI (R = 0.46; P < 0.05). No association with either OS or RFS was seen with univariate cox modelling. However, multivariable modelling for SMI with patient age, gender, race, smoking status, DLCO and FEV1 (% predicted), American Society of Anesthesiology (ASA) score, tumor histology and stage, and postoperative neoadjuvant therapy showed improved OS (HR = 0.97; P = 0.0005) and RFS (HR = 0.97; P = 0.01) with SMI. Using sex specific median SMI as cutoff, a lower SMI was associated with poor OS (HR = 1.65, P = 0.001) and RFS (HR = 1.47, P = 0.03).SMI is associated with improved outcomes after resection of NSCLC. Further studies are needed to understand the biological basis of this observation. This study provides additional rationale for designing and implementation of rehabilitation trials after surgical resection, to gain durable oncologic benefit.© 2023. BioMed Central Ltd., part of Springer Nature.