Sarcopenia/Muscle Mass is not a Prognostic Factor for Short- and Long-Term Outcome After Esophagectomy for Cancer

World J Surg. 2016 Nov;40(11):2698-2704. doi: 10.1007/s00268-016-3603-1.

Abstract

Background: Recent studies have suggested that sarcopenia is a prognostic risk indicator of postoperative complications and predicts survival in cancer patients. The aim of this study is to investigate whether sarcopenia is associated with postoperative short-term outcome (morbidity and mortality) and long-term survival in patients undergoing esophagectomy for cancer after neoadjuvant chemoradiotherapy.

Methods: All patients who underwent neoadjuvant chemoradiotherapy followed by esophagectomy for cancer, and of whom an adequate CT scan was available, were included in the current study. The presence of sarcopenia was defined by CT imaging using cut-off values of the total cross-sectional muscle tissue measured transversely at the third lumbar level.

Results: A total number of 120 patients were eligible for analysis. Almost half of the patients (N = 54, 45 %) were classified as having sarcopenia; 24 sarcopenic patients (44 %) had overweight and 5 sarcopenic patients (9 %) were obese. Overall morbidity and mortality rate did not differ significantly between sarcopenic and non-sarcopenic patients, nor did long-term overall or disease-free survival. Also sarcopenic obesity was not associated with worse outcome.

Conclusion: The presence of sarcopenia was not associated with a negative short- and long-term outcome in this selected group of esophageal cancer patients after neoadjuvant chemoradiotherapy followed by esophagectomy.

MeSH terms

  • Adult
  • Aged
  • Chemoradiotherapy
  • Cross-Sectional Studies
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Neoadjuvant Therapy
  • Overweight / complications
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Sarcopenia / complications
  • Sarcopenia / diagnostic imaging*
  • Sarcopenia / mortality
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult