{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:00:56Z","timestamp":1790398856084,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia or low muscle mass is common in non\u2010small cell lung cancer and predicts poorer outcomes, but its assessment typically relies on CT\u2010based skeletal muscle index at the L3 vertebral level. Standard chest CTs often omit the L3 level, leaving many patients without a straightforward muscle mass measure, so sarcopenia frequently goes undetected. We therefore evaluated whether thoracic CT measurements could reliably substitute for L3 SMI and developed a simple, accurate clinical tool to identify patients at risk of CT\u2010defined low muscle mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In retrospective (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009192) and prospective (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009177) cohorts of NSCLC patients, cross\u2010sectional muscle area was quantified on CT at L3, T12, and T4. Deming regression and Bland\u2013Altman analysis were used to assess correlations and agreement between T4\u2010 or T12\u2010derived SMI and reference L3 SMI. Candidate clinical predictors were selected based on univariate associations and clinical plausibility, and machine\u2010learning methods identified five routine variables, which were combined into the Lung Cancer Patients' Sarcopenia Risk Model (LSRM). Model performance was evaluated in terms of discrimination, calibration, and risk stratification and compared with established clinical indices like BMI and the advanced lung cancer inflammation index (ALI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>T12\u2010derived SMI showed a strong correlation and minimal bias versus L3, outperforming T4\u2010derived SMI. A conversion equation was established to estimate L3 SMI from T12. The LSRM, incorporating age, body mass index, carcinoembryonic antigen, C\u2010reactive protein, and lymphocyte count, demonstrated good discrimination, satisfactory calibration, and clear three\u2010tier risk stratification. It outperformed BMI and ALI in identifying CT\u2010defined low muscle mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>T12 measurements on routine chest CT can replace L3 for muscle assessment. The LSRM provides a practical bedside tool for screening patients at risk of CT\u2010defined low muscle mass in NSCLC without additional imaging, supporting earlier risk identification and integration into routine care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72230","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:44:19Z","timestamp":1790397859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pragmatic Screening for Sarcopenia in Non\u2010Small Cell Lung Cancer: Development and Internal Validation of a Prospective Risk Model Integrating\n                    <scp>T12 CT<\/scp>\n                    Indices and Routine Clinical Variables"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8795-5044","authenticated-orcid":false,"given":"Zhuorui","family":"You","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu Sichuan China"},{"name":"School of Medicine University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-1590","authenticated-orcid":false,"given":"Wei","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4222-6908","authenticated-orcid":false,"given":"Hechen","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-5633","authenticated-orcid":false,"given":"Xing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-515X","authenticated-orcid":false,"given":"Cheng","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0385-8032","authenticated-orcid":false,"given":"Jia","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieming","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Second Hospital of Lanzhou University  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8026-7330","authenticated-orcid":false,"given":"Minxian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of 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