{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:37:26Z","timestamp":1791067046876,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T00:00:00Z","timestamp":1699920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The obesity paradox in patients with advanced non\u2010small cell lung cancer receiving immune checkpoint inhibitor therapy has been observed, but its underlying mechanism is not fully understood. We aimed to investigate whether body composition affects the prognostic impact of obesity, as determined by body mass index (BMI), on survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study evaluated the data collected from Asian patients who were treated with immune checkpoint inhibitors for advanced non\u2010small cell lung cancer between October 2015 and October 2021. We used abdominal cross\u2010sectional imaging to calculate the skeletal muscle and visceral fat indices (cm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ) by dividing the cross\u2010sectional areas of the skeletal muscle and visceral fat by the height squared. Cox proportional\u2010hazards regression was performed to determine the correlation between BMI according to the Asia\u2010Pacific classification, body composition metrics and overall survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analysed the data of 820 patients (630 men and 190 women, with a mean age of 64.3\u00a0years [standard deviation: 10.4\u00a0years]) and observed 572 (69.8%) deaths with the 1\u2010year mortality rate of 0.58 (95% confidence interval, 0.55\u20130.62). Obese BMI was associated with longer overall survival, independent of clinical covariates (hazard ratio, 0.64; 95% confidence interval: 0.52\u20130.80). The prognostic value of obese BMI remained after additional adjustments for skeletal muscle index (hazard ratio, 0.68; 95% confidence interval, 0.53\u20130.87) or visceral fat index (hazard ratio, 0.54; 95% confidence interval: 0.41\u20130.70). No association was observed between sex and the impact of BMI on overall survival (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010value for interaction &gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Asian patients with advanced non\u2010small cell lung cancer who received immune checkpoint inhibitors, obese BMI was associated with favourable overall survival independent of skeletal muscle or visceral fat mass.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13367","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T15:53:20Z","timestamp":1700063600000},"page":"2898-2907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Obesity paradox in patients with non\u2010small cell lung cancer undergoing immune checkpoint inhibitor therapy"],"prefix":"10.1002","volume":"14","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\/0000-0003-0244-7714","authenticated-orcid":false,"given":"Danbee","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Design and Evaluation, The Samsung Advanced Institute for Health Sciences &amp; Technology (SAIHST) Sungkyunkwan University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2880-6730","authenticated-orcid":false,"given":"Jin Seok","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology\u2010Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4471-9565","authenticated-orcid":false,"given":"Eliseo","family":"Guallar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Medical Institutions  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-0266","authenticated-orcid":false,"given":"Juhee","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Design and Evaluation, The Samsung Advanced Institute for Health Sciences &amp; Technology (SAIHST) Sungkyunkwan University  Seoul Republic of Korea"},{"name":"Department of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Medical Institutions  Baltimore MD USA"},{"name":"Center for Clinical Epidemiology, Samsung Medical Center Sungkyunkwan University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9960-5648","authenticated-orcid":false,"given":"Ho Yun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"},{"name":"Department of Health Sciences and Technology, The Samsung Advanced Institute for Health Sciences &amp; Technology (SAIHST) Sungkyunkwan University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-17-3043"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13668-019-00280-6"},{"key":"e_1_2_7_4_1","first-page":"817","article-title":"Systematic review of prognostic roles of body mass index for patients undergoing lung cancer surgery: does the \u2018obesity paradox\u2019 really exist?","volume":"51","author":"Li S","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.5241"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-001460"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.5907"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.100482"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-nutr-082117-051723"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-17-0200"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.2722"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12333"},{"key":"e_1_2_7_13_1","article-title":"Association of adipopenia at preoperative PET\/CT with mortality in stage i non\u2010small cell lung cancer","volume":"30","author":"Choi H","year":"2021","journal-title":"Radiology"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2022-005226"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-00161-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2019.0470"},{"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","volume-title":"Regional Office for the Western Pacific. 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