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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

17-08-2022 | Esophageal Cancer | Thoracic Oncology

Prognostic Impact of the Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy on Older Patients with Esophageal Cancer

Authors: Tsuyoshi Harada, MSc, Tetsuya Tsuji, MD, PhD, Junya Ueno, Yu Koishihara, MSc, Nobuko Konishi, MSc, Nanako Hijikata, MD, Aiko Ishikawa, MD, PhD, Daisuke Kotani, MD, PhD, Takashi Kojima, MD, PhD, Hisashi Fujiwara, MD, PhD, Takeo Fujita, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Background

In older adults, skeletal muscle mass is an important factor for health and prognosis. The loss of SMM during neoadjuvant therapy affects the prognosis of patients with locally advanced esophageal cancer. However, information is limited regarding this possibility in older patients. This study aimed to establish the prognostic impact of SMM loss during neoadjuvant chemotherapy on older patients with locally advanced esophageal cancer.

Methods

This was a single-center retrospective cohort study. Patients age 65 years or older had undergone R0 curative esophagectomy after NAC. The skeletal muscle mass index before and after NAC was calculated from computed tomography images. The percentage change in the SMI during NAC (SMI%) was calculated from the SMI before and after NAC.

Results

The study analyzed 150 patients with a mean age of 71.1 ± 3.7 years. The mean value of the SMI was 42.7 ± 7.2 cm2/m2 before NAC, and the SMI% was − 6.4% ± 5.9%. The cutoff of SMI% for overall survival was defined by the log-rank test as − 12%. The Cox proportional hazard model showed that major loss of the SMI (≥ 12%) significantly influenced OS (hazard ratio, 2.490; 95% confidence interval, 1.121–5.529; p = 0.025) independently of age, sex, pathologic T and N factors, or treatment regimen.

Conclusions

Major SMI loss has an impact on OS after R0 curative esophagectomy for older patients with locally advanced esophageal cancer.
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Metadata
Title
Prognostic Impact of the Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy on Older Patients with Esophageal Cancer
Authors
Tsuyoshi Harada, MSc
Tetsuya Tsuji, MD, PhD
Junya Ueno
Yu Koishihara, MSc
Nobuko Konishi, MSc
Nanako Hijikata, MD
Aiko Ishikawa, MD, PhD
Daisuke Kotani, MD, PhD
Takashi Kojima, MD, PhD
Hisashi Fujiwara, MD, PhD
Takeo Fujita, MD, PhD
Publication date
17-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12379-2

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