非癌症相关预后因素（如身体构成）的预后意义在肿瘤学研究中引起了广泛关注。与肌肉萎缩相比，非小细胞肺癌患者脂肪组织对总生存期的预后意义尚不清楚。我们研究了非小细胞肺癌患者骨骼肌和脂肪组织的预后价值。本回顾性研究纳入了2014年1月至2016年12月期间确诊为非小细胞肺癌的4434名患者。检测其骨骼肌和皮下脂肪的横截面积，并自动计算心包脂肪容积。骨骼肌指数和皮下脂肪指数分别以骨骼肌面积和皮下脂肪面积除以身高的平方，心包脂肪指数则以心包脂肪容积除以体表面积计算。采用Cox比例风险模型评估体构与预后结果的关联。共纳入750例患者（男性501例[66.8%]，女性249例[33.2%]；平均年龄60.9±9.8岁）。与存活组相比，死亡组中肌肉萎缩（60.8% vs. 52.7%；P < 0.001）、减少的皮下脂肪指数（51.4% vs. 25.2%；P < 0.001）和减少的心包脂肪指数（55.4% vs. 16.5%；P < 0.001）更为常见。在多因素Cox回归分析中，经过临床变量调整后，增加的皮下脂肪指数（风险比[HR] = 0.56，95%置信区间[CI]：0.47-0.66，P < 0.001）和增加的心包脂肪指数（HR = 0.47，95% CI：0.40-0.56，P < 0.001）与较长的总生存期相关。对于I-III期患者，增加的皮下脂肪指数（HR = 0.62，95% CI：0.48-0.76，P < 0.001）和增加的心包脂肪指数（HR = 0.43，95% CI：0.34-0.54，P < 0.001）与更好的5年总生存率相关。IV期患者的结果类似。对于接受手术的患者，增加的皮下脂肪指数（HR = 0.60，95% CI：0.44-0.80，P = 0.001）和增加的心包脂肪指数（HR = 0.51，95% CI：0.38-0.68，P < 0.001）仍然与较好的总生存期相关。非手术患者的结果与手术患者类似。没有发现肌肉萎缩与总生存期的相关性（P > 0.05）。非小细胞肺癌中的增加的皮下脂肪指数和心包脂肪指数与更高的5年总生存率相关，与肌肉萎缩无关，可能表示非癌症相关死亡风险降低。© 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.

The prognostic significance of non-cancer-related prognostic factors, such as body composition, has gained extensive attention in oncological research. Compared with sarcopenia, the prognostic significance of adipose tissue for overall survival in non-small cell lung cancer remains unclear. We investigated the prognostic value of skeletal muscle and adipose tissue in patients with non-small cell lung cancer.This retrospective study included 4434 patients diagnosed with non-small cell lung cancer between January 2014 and December 2016. Cross-sectional areas of skeletal muscle and subcutaneous fat were measured, and the pericardial fat volume was automatically calculated. The skeletal muscle index and subcutaneous fat index were calculated as skeletal muscle area and subcutaneous fat area divided by height squared, respectively, and the pericardial fat index was calculated as pericardial fat volume divided by body surface area. The association between body composition and outcomes was evaluated using Cox proportional hazards model.A total of 750 patients (501 males [66.8%] and 249 females [33.2%]; mean age, 60.9 ± 9.8 years) were included. Sarcopenia (60.8% vs. 52.7%; P < 0.001), decreased subcutaneous fat index (51.4% vs. 25.2%; P < 0.001) and decreased pericardial fat index (55.4% vs. 16.5%; P < 0.001) were more commonly found in the deceased group than survived group. In multivariable Cox regression analysis, after adjusting for clinical variables, increased subcutaneous fat index (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.47-0.66, P < 0.001) and increased pericardial fat index (HR = 0.47, 95% CI: 0.40-0.56, P < 0.001) were associated with longer overall survival. For stage I-III patients, increased subcutaneous fat index (HR = 0.62, 95% CI: 0.48-0.76, P < 0.001) and increased pericardial fat index (HR = 0.43, 95% CI: 0.34-0.54, P < 0.001) were associated with better 5-year overall survival rate. Similar results were recorded in stage IV patients. For patients with surgery, the prognostic value of increased subcutaneous fat index (HR = 0.60, 95% CI: 0.44-0.80, P = 0.001) and increased pericardial fat index (HR = 0.51, 95% CI: 0.38-0.68, P < 0.001) remained and predicted favourable overall survival. Non-surgical patients showed similar results as surgical patients. No association was noted between sarcopenia and overall survival (P > 0.05).Increased subcutaneous fat index and pericardial fat index were associated with a higher 5-year overall survival rate, independent of sarcopenia, in non-small cell lung cancer and may indicate a reduced risk of non-cancer-related death.© 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.