Bethsabee Benadon1, Stéphanie Servagi-Vernat2, Laurent Quero3, Pierre Cattan4, Sophie Guillerm3, Valerie Hennequin3, Thomas Aparicio5, Nelson Lourenço5, Olivier Bouché6, Christophe Hennequin7. 1. Department of Oncology and Radiotherapy, Hopital Saint Louis, France; Department of Radiotherapy, Institut Godinot, Reims, France. 2. Department of Radiotherapy, Institut Godinot, Reims, France. 3. Department of Oncology and Radiotherapy, Hopital Saint Louis, France. 4. Department of digestive surgery, Hôpital Saint-Louis, Paris, France. 5. Department of Gastro-enterology, Hôpital Saint-Louis, Paris, France. 6. Department of Digestive oncology, CHU Reims, France. 7. Department of Oncology and Radiotherapy, Hopital Saint Louis, France. Electronic address: christophe.hennequin@sls.aphp.fr.
Abstract
INTRODUCTION: Sarcopenia is a prognostic factor of esophageal carcinoma (EC) before surgery, with less convincing data reported before chemoradiotherapy (CRT). MATERIAL AND METHODS: All patients with a locally advanced EC who had been treated with upfront CRT, between 2010 and 2015, were included. The decision of surgery was made after CRT (40-50 Gy). Muscle mass was measured on a single third lumbar vertebra CT-scan slice. Sarcopenia was internationally defined as skeletal muscle index of ≤39cm2/m2 for women and ≤55cm2/m2 for men. Results were additionally analyzed according to clinical parameters, with a cut-off based on the mean skeletal muscle lumbar index (SMI) of the population studied. RESULTS: Overall, 104 patients were included (male: 69%). Mean SMI was 35cm2/m2 for women and 46cm2/m2 for men, with 81% of patients being sarcopenic (n = 84). The 3-year overall survival (OS) rate, of 34.6%, was not significantly associated with sarcopenia in the whole population. In men, there was, however, a highly significant correlation between SMI and OS (p = 0.003), which remained significant upon multivariate analysis (p = 0.02). When using the mean SMI as cut-off, sarcopenia was significantly associated with 3-year OS (43.3% vs. 26.2%, p = 0.02). CONCLUSION: A high sarcopenia level appears negatively associated with OS in male EC patients treated with upfront CRT.
INTRODUCTION:Sarcopenia is a prognostic factor of esophageal carcinoma (EC) before surgery, with less convincing data reported before chemoradiotherapy (CRT). MATERIAL AND METHODS: All patients with a locally advanced EC who had been treated with upfront CRT, between 2010 and 2015, were included. The decision of surgery was made after CRT (40-50 Gy). Muscle mass was measured on a single third lumbar vertebra CT-scan slice. Sarcopenia was internationally defined as skeletal muscle index of ≤39cm2/m2 for women and ≤55cm2/m2 for men. Results were additionally analyzed according to clinical parameters, with a cut-off based on the mean skeletal muscle lumbar index (SMI) of the population studied. RESULTS: Overall, 104 patients were included (male: 69%). Mean SMI was 35cm2/m2 for women and 46cm2/m2 for men, with 81% of patients being sarcopenic (n = 84). The 3-year overall survival (OS) rate, of 34.6%, was not significantly associated with sarcopenia in the whole population. In men, there was, however, a highly significant correlation between SMI and OS (p = 0.003), which remained significant upon multivariate analysis (p = 0.02). When using the mean SMI as cut-off, sarcopenia was significantly associated with 3-year OS (43.3% vs. 26.2%, p = 0.02). CONCLUSION: A high sarcopenia level appears negatively associated with OS in male ECpatients treated with upfront CRT.
Authors: Josh McGovern; Ross D Dolan; Paul G Horgan; Barry J Laird; Donald C McMillan Journal: J Cachexia Sarcopenia Muscle Date: 2021-10-18 Impact factor: 12.910