{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:05:17Z","timestamp":1789664717871,"version":"4.0.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lung cancer remains a leading cause of cancer-related mortality, often exacerbated by malnutrition and muscle depletion that traditional weight-centric metrics may fail to identify. This study assessed the clinical and prognostic relevance of rectus femoris (RF) ultrasound as a practical bedside tool for evaluating muscle-related parameters and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This multicenter longitudinal study involved 374 patients (114 females, 260 males) across 10 Spanish hospitals. Researchers performed ultrasonographic assessments of the RF, measuring cross-sectional area (RF-CSA), thickness (\n                      <jats:italic>Y<\/jats:italic>\n                      -axis), and circumference, alongside GLIM malnutrition criteria and PG-SGA. Statistical analyses included Random Forest algorithms, ROC curves, and Cox regression models adjusted for age, BMI, ECOG performance status, cancer type, and cancer stage to determine sex-specific associations with clinical outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant sexual dimorphism was observed; men exhibited larger muscle parameters, while women had higher subcutaneous fat. RF-CSA and RF-\n                      <jats:italic>Y<\/jats:italic>\n                      -axis showed the highest discriminative performance for GLIM-defined malnutrition, with AUCs of 0.706 and 0.713 in men and 0.814 and 0.804 in women, respectively. The corresponding RF-CSA cut-offs were 3.88\u202fcm\n                      <jats:sup>2<\/jats:sup>\n                      in men and 2.78\u202fcm\n                      <jats:sup>2<\/jats:sup>\n                      in women, whereas RF-\n                      <jats:italic>Y<\/jats:italic>\n                      -axis cut-offs were 1.09\u202fcm in men and 0.95\u202fcm in women. In men, RF-\n                      <jats:italic>Y<\/jats:italic>\n                      -axis was significantly associated with all-cause mortality (HR\u202f=\u202f0.32, 95% CI: 0.15\u20130.71), whereas RF-CSA, RF-CIR, and RF-\n                      <jats:italic>X<\/jats:italic>\n                      -axis were associated with clinical complications. No significant associations with mortality or complications were observed in women. A moderate agreement was observed between GLIM and PG-SGA (weighted\n                      <jats:italic>\u03ba<\/jats:italic>\n                      =\u202f0.51), suggesting that these criteria capture overlapping but not identical dimensions of malnutrition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Rectus femoris ultrasound may provide objective, sex-specific clinical information that complements the GLIM framework and traditional anthropometric assessments. By identifying clinically relevant muscle waste, this bedside tool allows for the early detection of high-risk patients, potentially directing timely nutritional and rehabilitative interventions to improve survival and treatment tolerance in lung cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1876352","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:07:36Z","timestamp":1789661256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nutritional ultrasound cut off for predicting complications and mortality in lung cancer patients: a multicenter longitudinal study from the VALONC project"],"prefix":"10.3389","volume":"13","author":[{"given":"Jose M.","family":"Romero-M\u00e1rquez","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital","place":["Granada, Spain"]},{"name":"Foundation for Biosanitary Research of Eastern Andalusia\u2014Alejandro Otero (FIBAO)","place":["Granada, Spain"]},{"name":"Faculty of Health Sciences, Atlantic-Mediterranean Technological University (UTAMED)","place":["M\u00e1laga, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Gonz\u00e1lez-Pacheco","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Puerta del Mar University Hospital","place":["C\u00e1diz, Spain"]},{"name":"Instituto de Investigaci\u00f3n e Innovaci\u00f3n Biom\u00e9dica de C\u00e1diz (INiBICA), Hospital Universitario Puerta del Mar, Universidad de C\u00e1diz","place":["C\u00e1diz, Spain"]},{"name":"PhD Program in Clinical Medicine and Public Health, University of Granada","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Fern\u00e1ndez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital","place":["M\u00e1laga, Spain"]},{"name":"IBIMA Plataforma BIONAND, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga","place":["M\u00e1laga, Spain"]},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital","place":["M\u00e1laga, Spain"]},{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of M\u00e1laga","place":["M\u00e1laga, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Carmona-Llanos","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n e Innovaci\u00f3n Biom\u00e9dica de C\u00e1diz (INiBICA), Hospital Universitario Puerta del Mar, Universidad de C\u00e1diz","place":["C\u00e1diz, Spain"]},{"name":"Department of Endocrinology and Nutrition, Jerez Universitary Hospital","place":["Jerez de la Frontera, Spain"]},{"name":"Department of Nutrition and Food Sciencie, University of Granada","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Teresa","family":"Zarco-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Foundation for Biosanitary Research of Eastern Andalusia\u2014Alejandro Otero (FIBAO)","place":["Granada, Spain"]},{"name":"Endocrinology and Nutrition Unit, San Cecilio University Hospital","place":["Granada, Spain"]},{"name":"Granada Biosanitary Research Institute (ibs.GRANADA)","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Rodr\u00edguez","family":"de Vera-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Macarena Universitary Hospital","place":["Sevilla, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Mucarzel-Suarez-Arana","sequence":"additional","affiliation":[{"name":"Nutrition Support Unit, Endocrinology and Nutrition Department, Hospital Universitari Vall d\u2019Hebron","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garc\u00eda-Rey","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen del Roc\u00edo University Hospital","place":["Seville, Spain"]},{"name":"Instituto de Biomedicina de Sevilla (IBIS)","place":["Seville, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Sanz-Sanz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Reina Sof\u00eda University Hospital","place":["Cordoba, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel Rebollo","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Juan Ram\u00f3n Jim\u00e9nez University Hospital","place":["Huelva, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luisa","family":"Fernandez-Soto","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Unit, San Cecilio University Hospital","place":["Granada, Spain"]},{"name":"Granada Biosanitary Research Institute (ibs.GRANADA)","place":["Granada, Spain"]},{"name":"Department of Medicine, University of Granada","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Mustieles","sequence":"additional","affiliation":[{"name":"Granada Biosanitary Research Institute (ibs.GRANADA)","place":["Granada, Spain"]},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)","place":["Granada, Spain"]},{"name":"Servicio de Radiodiagn\u00f3stico, Hospital Universitario Cl\u00ednico San Cecilio","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araceli","family":"Mu\u00f1oz-Garach","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital","place":["Granada, Spain"]},{"name":"Granada Biosanitary Research Institute (ibs.GRANADA)","place":["Granada, Spain"]},{"name":"CIBER Fisiopatolog\u00eda de la obesidad y Nutrici\u00f3n (CIBERObn), Instituto Salud Carlos III","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Garc\u00eda-Almeida","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital","place":["M\u00e1laga, Spain"]},{"name":"IBIMA Plataforma BIONAND, Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga","place":["M\u00e1laga, Spain"]},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital","place":["M\u00e1laga, Spain"]},{"name":"Department of Medicine and Dermatology, Faculty of Medicine, University of M\u00e1laga","place":["M\u00e1laga, Spain"]},{"name":"CIBER Fisiopatolog\u00eda de la obesidad y Nutrici\u00f3n (CIBERObn), Instituto Salud Carlos III","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 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