Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy

Tomo Ishida, Tomoki Makino, Makoto Yamasaki, Koji Tanaka, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Masaaki Motoori, Yutaka Kimura, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

Abstract

Background: Some studies have reported that sarcopenia is linked to clinical outcomes in multiple types of malignancies, but this association has not been established in esophageal cancer. We assessed how sarcopenia affects clinical outcomes of multidisciplinary treatments for esophageal cancer. Methods: We included 165 esophageal cancer patients who had undergone neoadjuvant chemotherapy followed by esophagectomy. Computed tomography was used for cross-sectional measurement of the psoas muscle at the third lumbar vertebra; we then calculated the height-adjusted psoas muscle index. Pre- and postneoadjuvant chemotherapy psoas muscle indices were evaluated for associations with neoadjuvant chemotherapy response and neoadjuvant chemotherapy -related adverse events and postoperative complications, in addition to survival. Psoas muscle index cutoffs were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. Results: Psoas muscle index decreased after neoadjuvant chemotherapy (from 7.17 to 6.96 cm2/m2; P =.0008), and specifically in men (from 7.45 to 7.23 cm2/m2; P =.0001) but not in women (from 5.21 to 5.17 cm2/m2; P =.810). Preneoadjuvant chemotherapy psoas muscle index (low versus high) was associated with neoadjuvant chemotherapy response (response rate: 65.1% vs 80.3%; P =.0494) and neoadjuvant chemotherapy-related adverse events (neutropenia: 93.0% vs 78.7%; P =.0337; febrile neutropenia: 53.5% vs 34.3%; P =.0278; hyponatremia: 51.2% vs 31.2%; P =.0190). Post-neoadjuvant chemotherapy psoas muscle index correlated with postoperative rate of complications (56.9% vs 33.3%; P =.0046), especially pneumonia (31.4% vs 9.7% P =.0008). Psoas muscle index was not associated with survival. Conclusion: Cross sectional measures of sarcopenia before and after neoadjuvant chemotherapy could predict tumor response, neoadjuvant chemotherapy -related adverse events, and postoperative complications in multidisciplinary treatments for esophageal cancer.

Original languageEnglish
Pages (from-to)1041-1047
Number of pages7
JournalSurgery (United States)
Volume166
Issue number6
DOIs
Publication statusPublished - Dec 2019

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Esophagectomy
Esophageal Neoplasms
Psoas Muscles
Skeletal Muscle
Drug Therapy
Sarcopenia
Febrile Neutropenia
Lumbar Vertebrae
Survival
Hyponatremia
Neutropenia
Neoplasms
Pneumonia
Tomography

All Science Journal Classification (ASJC) codes

  • Surgery

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Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy. / Ishida, Tomo; Makino, Tomoki; Yamasaki, Makoto; Tanaka, Koji; Miyazaki, Yasuhiro; Takahashi, Tsuyoshi; Kurokawa, Yukinori; Motoori, Masaaki; Kimura, Yutaka; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro.

In: Surgery (United States), Vol. 166, No. 6, 12.2019, p. 1041-1047.

Research output: Contribution to journalArticle

Ishida, T, Makino, T, Yamasaki, M, Tanaka, K, Miyazaki, Y, Takahashi, T, Kurokawa, Y, Motoori, M, Kimura, Y, Nakajima, K, Mori, M & Doki, Y 2019, 'Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy', Surgery (United States), vol. 166, no. 6, pp. 1041-1047. https://doi.org/10.1016/j.surg.2019.07.033
Ishida, Tomo ; Makino, Tomoki ; Yamasaki, Makoto ; Tanaka, Koji ; Miyazaki, Yasuhiro ; Takahashi, Tsuyoshi ; Kurokawa, Yukinori ; Motoori, Masaaki ; Kimura, Yutaka ; Nakajima, Kiyokazu ; Mori, Masaki ; Doki, Yuichiro. / Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy. In: Surgery (United States). 2019 ; Vol. 166, No. 6. pp. 1041-1047.
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title = "Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy",
abstract = "Background: Some studies have reported that sarcopenia is linked to clinical outcomes in multiple types of malignancies, but this association has not been established in esophageal cancer. We assessed how sarcopenia affects clinical outcomes of multidisciplinary treatments for esophageal cancer. Methods: We included 165 esophageal cancer patients who had undergone neoadjuvant chemotherapy followed by esophagectomy. Computed tomography was used for cross-sectional measurement of the psoas muscle at the third lumbar vertebra; we then calculated the height-adjusted psoas muscle index. Pre- and postneoadjuvant chemotherapy psoas muscle indices were evaluated for associations with neoadjuvant chemotherapy response and neoadjuvant chemotherapy -related adverse events and postoperative complications, in addition to survival. Psoas muscle index cutoffs were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. Results: Psoas muscle index decreased after neoadjuvant chemotherapy (from 7.17 to 6.96 cm2/m2; P =.0008), and specifically in men (from 7.45 to 7.23 cm2/m2; P =.0001) but not in women (from 5.21 to 5.17 cm2/m2; P =.810). Preneoadjuvant chemotherapy psoas muscle index (low versus high) was associated with neoadjuvant chemotherapy response (response rate: 65.1{\%} vs 80.3{\%}; P =.0494) and neoadjuvant chemotherapy-related adverse events (neutropenia: 93.0{\%} vs 78.7{\%}; P =.0337; febrile neutropenia: 53.5{\%} vs 34.3{\%}; P =.0278; hyponatremia: 51.2{\%} vs 31.2{\%}; P =.0190). Post-neoadjuvant chemotherapy psoas muscle index correlated with postoperative rate of complications (56.9{\%} vs 33.3{\%}; P =.0046), especially pneumonia (31.4{\%} vs 9.7{\%} P =.0008). Psoas muscle index was not associated with survival. Conclusion: Cross sectional measures of sarcopenia before and after neoadjuvant chemotherapy could predict tumor response, neoadjuvant chemotherapy -related adverse events, and postoperative complications in multidisciplinary treatments for esophageal cancer.",
author = "Tomo Ishida and Tomoki Makino and Makoto Yamasaki and Koji Tanaka and Yasuhiro Miyazaki and Tsuyoshi Takahashi and Yukinori Kurokawa and Masaaki Motoori and Yutaka Kimura and Kiyokazu Nakajima and Masaki Mori and Yuichiro Doki",
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T1 - Impact of measurement of skeletal muscle mass on clinical outcomes in patients with esophageal cancer undergoing esophagectomy after neoadjuvant chemotherapy

AU - Ishida, Tomo

AU - Makino, Tomoki

AU - Yamasaki, Makoto

AU - Tanaka, Koji

AU - Miyazaki, Yasuhiro

AU - Takahashi, Tsuyoshi

AU - Kurokawa, Yukinori

AU - Motoori, Masaaki

AU - Kimura, Yutaka

AU - Nakajima, Kiyokazu

AU - Mori, Masaki

AU - Doki, Yuichiro

PY - 2019/12

Y1 - 2019/12

N2 - Background: Some studies have reported that sarcopenia is linked to clinical outcomes in multiple types of malignancies, but this association has not been established in esophageal cancer. We assessed how sarcopenia affects clinical outcomes of multidisciplinary treatments for esophageal cancer. Methods: We included 165 esophageal cancer patients who had undergone neoadjuvant chemotherapy followed by esophagectomy. Computed tomography was used for cross-sectional measurement of the psoas muscle at the third lumbar vertebra; we then calculated the height-adjusted psoas muscle index. Pre- and postneoadjuvant chemotherapy psoas muscle indices were evaluated for associations with neoadjuvant chemotherapy response and neoadjuvant chemotherapy -related adverse events and postoperative complications, in addition to survival. Psoas muscle index cutoffs were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. Results: Psoas muscle index decreased after neoadjuvant chemotherapy (from 7.17 to 6.96 cm2/m2; P =.0008), and specifically in men (from 7.45 to 7.23 cm2/m2; P =.0001) but not in women (from 5.21 to 5.17 cm2/m2; P =.810). Preneoadjuvant chemotherapy psoas muscle index (low versus high) was associated with neoadjuvant chemotherapy response (response rate: 65.1% vs 80.3%; P =.0494) and neoadjuvant chemotherapy-related adverse events (neutropenia: 93.0% vs 78.7%; P =.0337; febrile neutropenia: 53.5% vs 34.3%; P =.0278; hyponatremia: 51.2% vs 31.2%; P =.0190). Post-neoadjuvant chemotherapy psoas muscle index correlated with postoperative rate of complications (56.9% vs 33.3%; P =.0046), especially pneumonia (31.4% vs 9.7% P =.0008). Psoas muscle index was not associated with survival. Conclusion: Cross sectional measures of sarcopenia before and after neoadjuvant chemotherapy could predict tumor response, neoadjuvant chemotherapy -related adverse events, and postoperative complications in multidisciplinary treatments for esophageal cancer.

AB - Background: Some studies have reported that sarcopenia is linked to clinical outcomes in multiple types of malignancies, but this association has not been established in esophageal cancer. We assessed how sarcopenia affects clinical outcomes of multidisciplinary treatments for esophageal cancer. Methods: We included 165 esophageal cancer patients who had undergone neoadjuvant chemotherapy followed by esophagectomy. Computed tomography was used for cross-sectional measurement of the psoas muscle at the third lumbar vertebra; we then calculated the height-adjusted psoas muscle index. Pre- and postneoadjuvant chemotherapy psoas muscle indices were evaluated for associations with neoadjuvant chemotherapy response and neoadjuvant chemotherapy -related adverse events and postoperative complications, in addition to survival. Psoas muscle index cutoffs were 6.36 cm2/m2 for men and 3.92 cm2/m2 for women. Results: Psoas muscle index decreased after neoadjuvant chemotherapy (from 7.17 to 6.96 cm2/m2; P =.0008), and specifically in men (from 7.45 to 7.23 cm2/m2; P =.0001) but not in women (from 5.21 to 5.17 cm2/m2; P =.810). Preneoadjuvant chemotherapy psoas muscle index (low versus high) was associated with neoadjuvant chemotherapy response (response rate: 65.1% vs 80.3%; P =.0494) and neoadjuvant chemotherapy-related adverse events (neutropenia: 93.0% vs 78.7%; P =.0337; febrile neutropenia: 53.5% vs 34.3%; P =.0278; hyponatremia: 51.2% vs 31.2%; P =.0190). Post-neoadjuvant chemotherapy psoas muscle index correlated with postoperative rate of complications (56.9% vs 33.3%; P =.0046), especially pneumonia (31.4% vs 9.7% P =.0008). Psoas muscle index was not associated with survival. Conclusion: Cross sectional measures of sarcopenia before and after neoadjuvant chemotherapy could predict tumor response, neoadjuvant chemotherapy -related adverse events, and postoperative complications in multidisciplinary treatments for esophageal cancer.

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