Yuta Kawakita1, Satoru Motoyama2,3, Yusuke Sato2, Akiyuki Wakita2, Yushi Nagaki2, Kazuhiro Imai2, Yoshihiro Minamiya2. 1. Department of General Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. yutakawakita@gipc.akita-u.ac.jp. 2. Department of General Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. 3. Department of Comprehensive Cancer Control, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Abstract
BACKGROUND: Despite wide acknowledgement of the importance of sarcopenia and prognostic markers such as the neutrophil-to-lymphocyte ratio, the impact on cancer patient survival of the timing of sarcopenia's emergence and its severity is not well understood, nor is the association between sarcopenia and prognostic markers. The aim of this study, therefore, was to investigate the effect of the severity and timing of changes in the psoas muscle index (PMI) on survival of advanced esophageal squamous cell carcinoma (ESCC) patients receiving neoadjuvant chemoradiotherapy (NACRT) plus esophagectomy and the association between PMI and known prognostic markers. METHODS: Included in this study were 113 ESCC patients who underwent NACRT followed by esophagectomy. PMI and prognostic markers were measured at their initial visit, just before surgery (after NACRT), and 3 months postoperatively. RESULTS: All patients were classified into four groups according to the percent decrease in PMI after NACRT and after NACRT plus esophagectomy. Patients exhibiting a larger PMI decrease (≥20%) after NACRT plus esophagectomy had significantly poorer overall survival than those showing a smaller PMI decrease. Furthermore, multivariable analysis showed that a larger decrease in PMI after NACRT plus esophagectomy was a significant risk factor for overall (P < 0.0001) and recurrence-free (P = 0.0097) survival. Neither pretherapeutic PMI nor a decrease in PMI after NACRT significantly affected survival. PMI also showed weak, but significant, correlations with several prognostic markers postoperatively. CONCLUSIONS: Decreased PMI after NACRT plus esophagectomy is a strong prognostic indicator in ESCC patients.
BACKGROUND: Despite wide acknowledgement of the importance of sarcopenia and prognostic markers such as the neutrophil-to-lymphocyte ratio, the impact on cancerpatient survival of the timing of sarcopenia's emergence and its severity is not well understood, nor is the association between sarcopenia and prognostic markers. The aim of this study, therefore, was to investigate the effect of the severity and timing of changes in the psoas muscle index (PMI) on survival of advanced esophageal squamous cell carcinoma (ESCC) patients receiving neoadjuvant chemoradiotherapy (NACRT) plus esophagectomy and the association between PMI and known prognostic markers. METHODS: Included in this study were 113 ESCCpatients who underwent NACRT followed by esophagectomy. PMI and prognostic markers were measured at their initial visit, just before surgery (after NACRT), and 3 months postoperatively. RESULTS: All patients were classified into four groups according to the percent decrease in PMI after NACRT and after NACRT plus esophagectomy. Patients exhibiting a larger PMI decrease (≥20%) after NACRT plus esophagectomy had significantly poorer overall survival than those showing a smaller PMI decrease. Furthermore, multivariable analysis showed that a larger decrease in PMI after NACRT plus esophagectomy was a significant risk factor for overall (P < 0.0001) and recurrence-free (P = 0.0097) survival. Neither pretherapeutic PMI nor a decrease in PMI after NACRT significantly affected survival. PMI also showed weak, but significant, correlations with several prognostic markers postoperatively. CONCLUSIONS: Decreased PMI after NACRT plus esophagectomy is a strong prognostic indicator in ESCCpatients.
Authors: Yogesh K Vashist; Julian Loos; Josephine Dedow; Michael Tachezy; Guentac Uzunoglu; Asad Kutup; Emre F Yekebas; Jakob R Izbicki Journal: Ann Surg Oncol Date: 2010-10-28 Impact factor: 5.344
Authors: Kostan W Reisinger; Joanna W A M Bosmans; Martine Uittenbogaart; Abdulaziz Alsoumali; Martijn Poeze; Meindert N Sosef; Joep P M Derikx Journal: Ann Surg Oncol Date: 2015-04-17 Impact factor: 5.344