Among patients with advanced NSCLC, there is a group of patients with synchronous oligometastatic disease (sOMD), defined as a limited number of metastases detected at the time of diagnosis. As cachexia and sarcopenia are linked to poor survival, incorporating this information could assist clinicians in determining whether a radical treatment should be administered. In a retrospective multicenter study, including all patients with adequately staged (FDG-PET, brain imaging) sOMD according to the EORTC definition, we aimed to assess the relationship between cachexia and/or sarcopenia and survival. Of the 439 patients that were identified between 2015 and 2021, 234 met the criteria for inclusion and were included. The median age of the cohort was 67, 52.6% were male, and the median number of metastasis was 1. Forty-six (19.7%) patients had cachexia, thirty-four (14.5%) had sarcopenia and twenty-one (9.0%) had both. With a median follow-up of 49.7 months, median PFS and OS were 8.6 and 17.3 months, respectively. Moreover, a trend toward longer PFS was found in patients without cachexia and sarcopenia compared to those with cachexia and/or sarcopenia. In multivariate analysis, cachexia and sarcopenia were not associated with an inferior survival, irrespective of receiving radical treatment. High CRP was associated with inferior survival and could be a prognostic factor, helping the decision of clinicians in selecting patients who may benefit from the addition of LRT. However, despite the homogeneous definition of oligometastatic disease and the adequate staging, our subgroups were small. Therefore, further studies are needed to better understand our hypothesis and generating findings.
在晚期非小细胞肺癌患者中，存在一组同步寡转移性疾病患者，其定义为诊断时检测到有限数量的转移灶。鉴于恶病质和肌肉减少症与不良生存率相关，整合此类信息有助于临床医生判断是否应采取根治性治疗。在一项回顾性多中心研究中，我们依据欧洲癌症研究与治疗组织的定义，纳入了所有经充分分期（FDG-PET、脑部影像学检查）的同步寡转移性疾病患者，旨在评估恶病质和/或肌肉减少症与生存率的关系。2015年至2021年间共筛查出439例患者，其中234例符合纳入标准。队列中位年龄为67岁，52.6%为男性，中位转移灶数量为1个。46例（19.7%）患者存在恶病质，34例（14.5%）存在肌肉减少症，21例（9.0%）同时患有这两种病症。中位随访时间为49.7个月，中位无进展生存期和总生存期分别为8.6个月和17.3个月。此外，与存在恶病质和/或肌肉减少症的患者相比，无这两种病症的患者显示出更长的无进展生存期趋势。在多变量分析中，无论是否接受根治性治疗，恶病质和肌肉减少症均未与较差的生存率相关。高C反应蛋白水平与较差的生存率相关，可能作为预后因素，辅助临床医生筛选可能从局部根治性治疗中获益的患者。然而，尽管采用了标准化的寡转移疾病定义和充分的分期评估，本研究亚组样本量较小，因此需要进一步研究以深入验证我们的假设并得出更明确的结论。
肿瘤(癌症)患者之家