Top

Published in:

01-10-2014 | Thoracic Oncology

Changes in Body Composition Secondary to Neoadjuvant Chemotherapy for Advanced Esophageal Cancer are Related to the Occurrence of Postoperative Complications After Esophagectomy

Authors: Satoshi Ida, MD, PhD, Masayuki Watanabe, MD, PhD, FACS, Ryuichi Karashima, MD, Yu Imamura, MD, PhD, Takatsugu Ishimoto, MD, PhD, Yoshifumi Baba, MD, PhD, Shiro Iwagami, MD, PhD, Yasuo Sakamoto, MD, PhD, Yuji Miyamoto, MD, PhD, Naoya Yoshida, MD, PhD, FACS, Hideo Baba, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 11/2014

Abstract

Background

Although a survival benefit of neoadjuvant treatment for patients with esophageal cancer has been highlighted, the influence of neoadjuvant treatment on the nutritional status of patients with esophageal cancer is not well understood.

Methods

Changes in body composition parameters were assessed in 30 patients who underwent neoadjuvant chemotherapy (NAC) comprising docetaxel, cisplatin, and 5-fluorouracil followed by esophagectomy from August 2009 to April 2013. Body composition was evaluated before and after NAC using multifrequency bioelectrical impedance analysis (InBody 720; Biospace, Tokyo, Japan). Postoperative complications were graded according to the Clavien-Dindo classification.

Results

Twenty-three postoperative events occurred in 16 patients. A decrease in body protein was observed in 13 patients (43.3 %), while skeletal muscle (SM), body cell mass (BCM), and fat-free mass (FFM) declined in 11 patients (36.7 %) during NAC. Changes in these four parameters during chemotherapy significantly differed between patients with postoperative complications and those without: protein, −1.6 ± 0.9 versus +4.4 ± 2.1 kg (P = 0.01); SM, −1.3 ± 1.1 versus +4.7 ± 2.4 kg (P = 0.02); BCM, −2.4 ± 1.6 versus +3.8 ± 2.2 kg (P = 0.03); and FFM, −1.4 ± 1.4 versus +4.3 ± 2.3 kg (P = 0.04).

Conclusions

Changes in body composition parameters are possible predictive markers of postoperative complications after esophagectomy after NAC. Further analysis is needed to clarify whether nutritional intervention improves such parameters and thus contributes to reduced postoperative morbidity.

Available only for authorised users

Earlam R, Cunha-Melo JR. Oesophageal squamous cell carcinoma: I. A critical review of surgery. Br J Surg. 1980;67:381–90.PubMedCrossRef

Wu PC, Posner MC. The role of surgery in the management of oesophageal cancer. Lancet Oncol. 2003;4:481–8.PubMedCrossRef

Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol. 2011;12:681–92.PubMedCrossRef

Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.PubMedCrossRef

Hirao M, Ando N, Tsujinaka T, et al. Influence of preoperative chemotherapy for advanced thoracic oesophageal squamous cell carcinoma on perioperative complications. Br J Surg. 2011;98:1735–41.PubMedCrossRef

Watanabe M, Nagai Y, Kinoshita K, et al. Induction chemotherapy with docetaxel/cisplatin/5-fluorouracil for patients with node-positive esophageal cancer. Digestion. 2011;83:146–52.PubMedCrossRef

Yoshida N, Watanabe M, Baba Y, et al. Influence of preoperative docetaxel, cisplatin, and 5-fluorouracil on the incidence of complications after esophagectomy for resectable advanced esophageal cancer. Dis Esophagus. 2014;27:374–9.

Jaffrin MY, Morel H. Body fluid volumes measurements by impedance: a review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys. 2008;30:1257–69.PubMedCrossRef

Kim M, Kim H. Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older. Eur J Clin Nutr. 2013;67:395–400.PubMedCrossRef

10.

Kaido T, Mori A, Ogura Y, et al. Pre- and perioperative factors affecting infection after living donor liver transplantation. Nutrition. 2012;28:1104–8.PubMedCrossRef

11.

Sobin LH, Gospodarowicz MK, Wittekind CW. TNM classification of malignant tumours. 7th ed. New York: Wiley-Blackwell; 2009.

12.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCrossRefPubMedCentral

13.

Grotenhuis BA, Wijnhoven BP, Grune F, van Bommel J, Tilanus HW, van Lanschot JJ. Preoperative risk assessment and prevention of complications in patients with esophageal cancer. J Surg Oncol. 2010;101:270–8.PubMed

14.

Nozoe T, Kimura Y, Ishida M, Saeki H, Korenaga D, Sugimachi K. Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol. 2002;28:396–400.PubMedCrossRef

15.

Ryan AM, Reynolds JV, Healy L, et al. Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial. Ann Surg. 2009;249:355–63.PubMedCrossRef

16.

Dewys WD, Begg C, Lavin PT, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. Am J Med. 1980;69:491–7.PubMedCrossRef

17.

Han-Geurts IJ, Hop WC, Tran TC, Tilanus HW. Nutritional status as a risk factor in esophageal surgery. Dig Surg. 2006;23:159–63.PubMedCrossRef

18.

Chen Z, Wang Z, Lohman T, et al. Dual-energy X-ray absorptiometry is a valid tool for assessing skeletal muscle mass in older women. J Nutr. 2007;137:2775–80.PubMed

19.

Jackson W, Alexander N, Schipper M, Fig L, Feng F, Jolly S. Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual-energy X-ray absorptiometry (DEXA). Head Neck. 2013. doi:10.1002/hed.23461.

20.

Hennessey DB, Burke JP, Ni-Dhonochu T, Shields C, Winter DC, Mealy K. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi-institutional study. Ann Surg. 2010;252:325–9.PubMedCrossRef

21.

Kawaguchi T, Taniguchi E, Itou M, et al. Body cell mass is a useful parameter for assessing malnutrition and severity of disease in non-ascitic cirrhotic patients with hepatocellular carcinoma or esophageal varices. Int J Mol Med. 2008;22:589–94.PubMed

22.

Peng PD, van Vledder MG, Tsai S, et al. Sarcopenia negatively impacts short-term outcomes in patients undergoing hepatic resection for colorectal liver metastasis. HPB (Oxford). 2011;13:439–46.PubMedCrossRefPubMedCentral

Title: Changes in Body Composition Secondary to Neoadjuvant Chemotherapy for Advanced Esophageal Cancer are Related to the Occurrence of Postoperative Complications After Esophagectomy
Authors: Satoshi Ida, MD, PhD
Masayuki Watanabe, MD, PhD, FACS
Ryuichi Karashima, MD
Yu Imamura, MD, PhD
Takatsugu Ishimoto, MD, PhD
Yoshifumi Baba, MD, PhD
Shiro Iwagami, MD, PhD
Yasuo Sakamoto, MD, PhD
Yuji Miyamoto, MD, PhD
Naoya Yoshida, MD, PhD, FACS
Hideo Baba, MD, PhD, FACS
Publication date: 01-10-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 11/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3737-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in Body Composition Secondary to Neoadjuvant Chemotherapy for Advanced Esophageal Cancer are Related to the Occurrence of Postoperative Complications After Esophagectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2014

Survival Analysis of Contralateral Prophylactic Mastectomy: A Question of Selection Bias

Predicting the Extent of Nodal Disease in Early-Stage Breast Cancer

Systematic Review of FDG-PET Prediction of Complete Pathological Response and Survival in Rectal Cancer

Adjuvant Imatinib for GIST: The Pie is Shrinking

Challenges in the Local Treatment of Large Abdominal Embryonal Rhabdomyosarcoma

Breast Pathology Review: Does It Make a Difference?