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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2018

01-02-2018 | Thoracic Oncology

Impact of Sarcopenia on Unplanned Readmission and Survival After Esophagectomy in Patients with Esophageal Cancer

Authors: Daisuke Makiura, PhD, Rei Ono, PhD, Junichiro Inoue, PhD, Akimasa Fukuta, RPT, Miyuki Kashiwa, MSc, Yasushi Miura, PhD, Taro Oshikiri, PhD, Tetsu Nakamura, PhD, Yoshihiro Kakeji, PhD, Yoshitada Sakai, PhD

Published in: Annals of Surgical Oncology | Issue 2/2018

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Abstract

Background

Although sarcopenia increases postoperative complications following esophagectomy, its effects on prognosis remain unclear. This study was performed to identify the effect of sarcopenia on 90-day unplanned readmission and overall survival (OS) after esophagectomy.

Methods

Ninety-eight patients with esophageal cancer who underwent esophagectomy were enrolled in this study. Unplanned readmission was defined as any emergent hospitalization within 90 days after discharge. Sarcopenia, defined as low muscle mass plus low muscle strength and/or low physical performance according to the Asian consensus definition, was assessed prior to esophagectomy. Multivariate logistic regression analysis was performed to identify factors that contributed to 90-day unplanned readmission. OS was estimated using the Kaplan–Meier method, and a Cox proportional hazards model was used to assess the relationship between sarcopenia and OS.

Results

Thirty-one patients (31.6%) were diagnosed with sarcopenia. The 90-day unplanned readmission rate was significantly higher in patients with sarcopenia than those without (42.9% vs. 16.4%, respectively; p = 0.01). Multivariable logistic regression analysis showed that sarcopenia was an independent predictor of 90-day unplanned readmission [odds ratio 3.71, 95% confidence interval (CI) 1.29–11.05; p = 0.02], and the log-rank test showed that sarcopenia was associated with OS (p = 0.01). Moreover, sarcopenia was a significant predictor of OS after adjustment for age, sex, and pathological stage (hazard ratio 2.35, 95% CI 1.21–4.54; p = 0.01).

Conclusions

Sarcopenia is a risk factor for 90-day unplanned readmission and OS following esophagectomy. Assessment of sarcopenia could help to identify patients at higher risk of a poor prognosis after esophagectomy.
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Metadata
Title
Impact of Sarcopenia on Unplanned Readmission and Survival After Esophagectomy in Patients with Esophageal Cancer
Authors
Daisuke Makiura, PhD
Rei Ono, PhD
Junichiro Inoue, PhD
Akimasa Fukuta, RPT
Miyuki Kashiwa, MSc
Yasushi Miura, PhD
Taro Oshikiri, PhD
Tetsu Nakamura, PhD
Yoshihiro Kakeji, PhD
Yoshitada Sakai, PhD
Publication date
01-02-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-6294-4

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