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European Radiology
Published in: European Radiology 5/2014

01-05-2014 | Oncology

Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

Authors: Connie Yip, Vicky Goh, Andrew Davies, James Gossage, Rosalind Mitchell-Hay, Orla Hynes, Nick Maisey, Paul Ross, Andrew Gaya, David B. Landau, Gary J. Cook, Nyree Griffin, Robert Mason

Published in: European Radiology | Issue 5/2014

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Abstract

Objectives

Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer.

Methods

A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS).

Results

Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 % ± 6.4 (SD) in comparison to FM index (−1.2 ± 4.2), FFM index (−4.6 ± 6.8), FMR (−1.2 ± 24.3) and VA/SA (−62.3 ± 12.7). Changes in FM index (p = 0.022), FMR (p = 0.028), VA/SA (p = 0.024) and weight (p = 0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival.

Conclusions

Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity.

Key Points

• Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer.
• Sarcopenia was more prevalent after neoadjuvant chemotherapy.
• Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy.
• Changes in body composition were associated with CRM positivity.
• Changes in body composition did not affect perioperative complications and survival.
Appendix
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Metadata
Title
Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer
Authors
Connie Yip
Vicky Goh
Andrew Davies
James Gossage
Rosalind Mitchell-Hay
Orla Hynes
Nick Maisey
Paul Ross
Andrew Gaya
David B. Landau
Gary J. Cook
Nyree Griffin
Robert Mason
Publication date
01-05-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3110-4

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