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Published in: Surgery Today 12/2019

01-12-2019 | Esophageal Cancer | Original Article

Association of skeletal muscle loss with the long-term outcomes of esophageal cancer patients treated with neoadjuvant chemotherapy

Authors: Naoki Kamitani, Kazuhiro Migita, Sohei Matsumoto, Kohei Wakatsuki, Tomohiro Kunishige, Hiroshi Nakade, Shintaro Miyao, Masayuki Sho

Published in: Surgery Today | Issue 12/2019

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Abstract

Purpose

To investigate the change in skeletal muscle mass and evaluate the prognostic impact of sarcopenia on esophageal cancer (EC) patients

Methods

The subjects of this retrospective study were 90 EC patients who were treated with neoadjuvant chemotherapy (NAC) and subsequent esophagectomy. The skeletal muscle index (SMI) was defined according to computed tomography (CT) imaging of the total cross-sectional muscle tissue, measured at the third lumbar level using a volume analyzer before NAC and surgery. The SMI was calculated by normalization according to height, and skeletal muscle loss (SML) was defined as (pre-NAC SMI value − preoperative SMI value) × 100/pre-NAC SMI.

Results

Sarcopenia was evident in 72 (80.0%) patients before NAC and 77 (85.6%) patients before NAC and surgery. The SMI value was decreased in 28 (68.9%) patients and the median SML was 3.3%. The 3-year overall survival rate was 68.9% in the low SML group and 0% in the high SML group (P < 0.001). Sarcopenia before NAC or surgery was not significantly associated with overall survival. Multivariable analysis identified high SML as an independent prognostic factor.

Conclusions

These results suggest that skeletal muscle loss is associated with a worse long-term outcome for EC patients treated with NAC.
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Metadata
Title
Association of skeletal muscle loss with the long-term outcomes of esophageal cancer patients treated with neoadjuvant chemotherapy
Authors
Naoki Kamitani
Kazuhiro Migita
Sohei Matsumoto
Kohei Wakatsuki
Tomohiro Kunishige
Hiroshi Nakade
Shintaro Miyao
Masayuki Sho
Publication date
01-12-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 12/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01846-1

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