Extracellular Water-to-total Body Water Ratio as an Objective Biomarker for Frailty in Lung Cancer Patients

Background/Aim: Our previous study revealed the association between extracellular water-to-total body water ratio (ECW/TBW) and the therapeutic durability of chemotherapy and/or immune checkpoint inhibitors in advanced lung cancer. We retrospectively examined the usefulness of ECW/TBW in detecting frailty compared to other bioelectrical impedance (BIA) parameters in a larger number of patients. Patients and Methods: Lung cancer patients underwent BIA before anti-cancer therapy at our hospital between June 1, 2018 and July 31, 2020. Results: Of 99 patients, 26 were assigned to ECW/TBW?0.4 (higher group: HG) and 57 to ECW/TBW<0.4 (lower group: LG). ECW/TBW increased significantly with performance deterioration and ageing. HG patients had significantly shorter time-to-treatment failure (TTF) than LG patients. In patients with performance status 0-1, those in the HG had shorter TTF than those in the LG. ECW/TBW was the only independent predictor of TTF according to multivariate analysis. Conclusion: ECW/TBW is an objective biomarker for detecting frailty among lung cancer patients.

Automated summary

The study found that extracellular water-to-total body water ratio (ECW/TBW) is an effective biomarker for detecting frailty among lung cancer patients. ECW/TBW significantly increases with performance deterioration and aging, and patients with higher ECW/TBW have shorter time-to-treatment failure compared to those with lower ECW/TBW.