Ryosuke Kita1, Hiroshi Miyata2, Keijiro Sugimura1, Koji Tanaka3, Tomoki Makino3, Kotaro Yamashita3, Makoto Yamasaki3, Masaaki Motoori4, Osamu Shiraishi5, Yutaka Kimura5, Takushi Yasuda5, Masahiko Yano1, Yuichiro Doki3. 1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan. 2. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan. Electronic address: hmiyata@gesurg.med.osaka-u.ac.jp. 3. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. 4. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan; Department of Surgery, Osaka General Medical Center, Osaka, Japan. 5. Department of Surgery, Kinki University, Osaka, Japan.
Abstract
BACKGROUND & AIMS: Reductions in skeletal muscle mass during neoadjuvant therapy can have a negative effect on short- and long-term outcomes in patients with esophageal cancer. However, effective treatment for suppressing reductions in skeletal muscle mass during neoadjuvant therapy has not been established. METHODS: Eighty-seven patients were included in this study who were enrolled in a previous randomized study comparing the effects of enteral nutrition (EN) and parenteral nutrition (PN) on chemotherapy-related toxicities during neoadjuvant chemotherapy in esophageal cancer patients. Changes in skeletal muscle mass during neoadjuvant therapy were compared between the two groups. RESULTS: Skeletal muscle mass index (SMI) decreased from 45.8 cm2/m2 before treatment to 43.7 cm2/m2 after neoadjuvant chemotherapy in 87 patients (p = 0.092). The total calorie intake during neoadjuvant therapy was equal between the two groups. SMI reduction was significantly smaller in the EN group than in the PN group (-1.4 cm2/m2 vs -3.0 cm2/m (Gebski et al., 2007) [2], p < 0.001). EN support was identified as the only independent factor adversely associated with severe SMI reduction (p < 0.001). Patients with low SMI after neoadjuvant chemotherapy were more susceptible to postoperative complications than patients with moderate SMI (47.6% vs 16.7%, p = 0.007), especially pulmonary complications (31.8% vs 10.8%, p = 0.003). Patients with low SMI after neoadjuvant chemotherapy tended to show worse prognosis than patients with moderate SMI (5-year overall survival rate: 43.8% vs 62.1%, p = 0.194). CONCLUSIONS: Compared with PN support, EN support during neoadjuvant chemotherapy suppressed reductions in skeletal muscle mass in patients with esophageal cancer.
BACKGROUND & AIMS: Reductions in skeletal muscle mass during neoadjuvant therapy can have a negative effect on short- and long-term outcomes in patients with esophageal cancer. However, effective treatment for suppressing reductions in skeletal muscle mass during neoadjuvant therapy has not been established. METHODS: Eighty-seven patients were included in this study who were enrolled in a previous randomized study comparing the effects of enteral nutrition (EN) and parenteral nutrition (PN) on chemotherapy-related toxicities during neoadjuvant chemotherapy in esophageal cancer patients. Changes in skeletal muscle mass during neoadjuvant therapy were compared between the two groups. RESULTS: Skeletal muscle mass index (SMI) decreased from 45.8 cm2/m2 before treatment to 43.7 cm2/m2 after neoadjuvant chemotherapy in 87 patients (p = 0.092). The total calorie intake during neoadjuvant therapy was equal between the two groups. SMI reduction was significantly smaller in the EN group than in the PN group (-1.4 cm2/m2 vs -3.0 cm2/m (Gebski et al., 2007) [2], p < 0.001). EN support was identified as the only independent factor adversely associated with severe SMI reduction (p < 0.001). Patients with low SMI after neoadjuvant chemotherapy were more susceptible to postoperative complications than patients with moderate SMI (47.6% vs 16.7%, p = 0.007), especially pulmonary complications (31.8% vs 10.8%, p = 0.003). Patients with low SMI after neoadjuvant chemotherapy tended to show worse prognosis than patients with moderate SMI (5-year overall survival rate: 43.8% vs 62.1%, p = 0.194). CONCLUSIONS: Compared with PN support, EN support during neoadjuvant chemotherapy suppressed reductions in skeletal muscle mass in patients with esophageal cancer.
Authors: Florian Huemer; Stefan Hecht; Bernhard Scharinger; Verena Schlintl; Gabriel Rinnerthaler; Konstantin Schlick; Ronald Heregger; Thomas Melchardt; Angela Wimmer; Iris Mühlbacher; Oliver Owen Koch; Daniel Neureiter; Eckhard Klieser; Sara Seyedinia; Mohsen Beheshti; Richard Greil; Lukas Weiss Journal: J Cancer Res Clin Oncol Date: 2022-07-21 Impact factor: 4.322