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.
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.
Authors: Jennifer L Kuk; Peter T Katzmarzyk; Milton Z Nichaman; Timothy S Church; Steven N Blair; Robert Ross Journal: Obesity (Silver Spring) Date: 2006-02 Impact factor: 5.002
Authors: Carla M M Prado; Vickie E Baracos; Linda J McCargar; Tony Reiman; Marina Mourtzakis; Katia Tonkin; John R Mackey; Sheryl Koski; Edith Pituskin; Michael B Sawyer Journal: Clin Cancer Res Date: 2009-04-07 Impact factor: 12.531
Authors: Marina Mourtzakis; Carla M M Prado; Jessica R Lieffers; Tony Reiman; Linda J McCargar; Vickie E Baracos Journal: Appl Physiol Nutr Metab Date: 2008-10 Impact factor: 2.665
Authors: M D Goncalves; S Taylor; D F Halpenny; E Schwitzer; S Gandelman; J Jackson; A Lukose; A J Plodkowski; K S Tan; M Dunphy; L W Jones; R J Downey Journal: Clin Radiol Date: 2018-01-06 Impact factor: 2.350
Authors: Chun Seng Lee; David J Murphy; Colm McMahon; Blathnaid Nolan; Garret Cullen; Hugh Mulcahy; Kieran Sheahan; Elizabeth Barnes; David Fennelly; Elizabeth J Ryan; Glen A Doherty Journal: J Gastrointest Cancer Date: 2015-09
Authors: Minji Jang; Hyung Woo Park; Jimi Huh; Jong Hwa Lee; Yoong Ki Jeong; Yang Won Nah; Jisuk Park; Kyung Won Kim Journal: Eur Radiol Date: 2018-11-07 Impact factor: 5.315
Authors: Dietmar Tamandl; Richard M Gore; Barbara Fueger; Patrick Kinsperger; Michael Hejna; Matthias Paireder; Alexander Haug; Sebastian F Schoppmann; Ahmed Ba-Ssalamah Journal: Eur Radiol Date: 2015-06-05 Impact factor: 5.315
Authors: Katelin A Mirkin; Franklyn E Luke; Alexandra Gangi; Jose M Pimiento; Daniel Jeong; Christopher S Hollenbeak; Joyce Wong Journal: J Gastrointest Oncol Date: 2017-06
Authors: Bennett G Childs; Martina Gluscevic; Darren J Baker; Remi-Martin Laberge; Dan Marquess; Jamie Dananberg; Jan M van Deursen Journal: Nat Rev Drug Discov Date: 2017-07-21 Impact factor: 84.694