{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:25:26Z","timestamp":1789766726231,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although the obesity paradox is a topic of immense interest for oncologists and epidemiologists, the mechanism underlying this unexpected benefit of obesity is poorly understood. We explored the prognostic value of obesity and its association with skeletal muscle mass.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study evaluated the data of patients who underwent surgical excision for lung adenocarcinoma between January 2011 and December 2015. Body mass index was categorized according to the criteria of the Asia\u2010Pacific classification. Cross\u2010sectional areas of the skeletal muscle, subcutaneous fat, and visceral fat were measured. Skeletal muscle mass status was defined based on the cut\u2010offs of skeletal muscle index (cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>), calculated as the area of skeletal muscle divided by height squared. Overall survival was estimated using the Kaplan\u2013Meier method, and differences in survival probabilities were compared using the log\u2010rank test. Cox proportional hazards regression analysis was conducted to determine the association with overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 636 patients with a median age of 61\u00a0years (interquartile range, 54.0\u201368.5\u00a0years; 321 men and 315 women) were included. Obese patients (body mass index\u00a0\u2265\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>) had longer overall survival than non\u2010obese patients (mean, 110.2\u00a0months vs. 98.7\u00a0months; log\u2010rank <jats:italic>P<\/jats:italic>\u00a0=\u00a00.015). Under multivariable Cox proportional hazard regression analysis, obesity was associated with longer overall survival after adjusting for covariates (hazard ratio, 0.59; 95% confidence interval, 0.40\u20130.86; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). The prognostic value of obesity remained and predicted favourable overall survival after additional adjusting for skeletal muscle mass status (hazard ratio, 0.57; 95% confidence interval, 0.36\u20130.89; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.014), skeletal muscle index (hazard ratio, 0.53; 95% confidence interval, 0.33\u20130.84; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008), or skeletal muscle area (hazard ratio, 0.61; 95% confidence interval, 0.38\u20130.98; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.041). No association was observed between skeletal muscle mass status and the impact of body mass index on overall survival (<jats:italic>P<\/jats:italic> for interaction\u00a0=\u00a00.512).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obesity was associated with favourable overall survival, independent of skeletal muscle mass, after surgical excision of lung adenocarcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12956","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T09:30:59Z","timestamp":1645781459000},"page":"1076-1086","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Obesity is associated with improved postoperative overall survival, independent of skeletal muscle mass in lung adenocarcinoma"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8582-5436","authenticated-orcid":false,"given":"Ji Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Radiology Samsung Medical Center, Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-5344","authenticated-orcid":false,"given":"Young Cheol","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Radiology Samsung Medical Center, Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology Samsung Medical Center, Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jae","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Radiology Chung\u2010Ang University Hospital, Chung\u2010Ang University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology Samsung Medical Center, Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyunga","family":"Kim","sequence":"additional","affiliation":[{"name":"Biomedical Statistics Center Research Institute for Future Medicine, Samsung Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Seung","family":"Kim","sequence":"additional","affiliation":[{"name":"Biomedical Statistics Center Research Institute for Future Medicine, Samsung Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41419-017-0063-y"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181d2dcd9"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.171016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.4680"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02640414.2011.553965"},{"key":"e_1_2_7_8_1","first-page":"817","article-title":"Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the'obesity paradox' really exist?","volume":"51","author":"Li S","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-17-3043"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-020-01124-x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000690"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2018.04.035"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00744.2004"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1139\/H08-075"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70153-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-88441-7"},{"key":"e_1_2_7_19_1","volume-title":"Regional Office for the Western Pacific. 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