Neoadjuvant Chemoradiotherapy for Patients with cT3/Nearly T4 Esophageal Cancer: Is Sarcopenia Correlated with Postoperative Complications and Prognosis?

Hiroshi Saeki, Yuichiro Nakashima, Kensuke Kudou, Shun Sasaki, Tomoko Jogo, Kosuke Hirose, Keitaro Edahiro, Shotaro Korehisa, Daisuke Taniguchi, Ryota Nakanishi, Nobuhide Kubo, Koji Ando, Akira Kabashima, Eiji Oki, Yoshihiko Maehara

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Abstract

Background: Since the clinical impact of sarcopenia on multimodal therapy for patients with esophageal cancer is not well understood, this study was conducted to determine the influence of sarcopenia on the efficacy of neoadjuvant chemoradiotherapy (NACRT) for locally advanced esophageal cancer. Methods: The skeletal muscle index was quantified at the level of the third lumbar vertebra on computed tomography images, and sarcopenia was defined as a skeletal muscle index that was less than the average for each gender. We compared treatment outcomes in patients with cT3 and nearly T4 thoracic esophageal squamous cell carcinoma between the sarcopenia group (n = 85) and the non-sarcopenia group (n = 72). Results: The 5-year survival rates were 33.4% in the non-sarcopenia group and 31.5% in the sarcopenia group; these differences were not significant. The prognosis of the patients with sarcopenia was worse than that of the patients without sarcopenia in the surgery-alone group, but there was no difference between patients with and without sarcopenia in the NACRT group. Conclusions: NACRT could be a useful option for patients with locally advanced esophageal squamous cell carcinoma, even for those with sarcopenia, without increasing the incidence of morbidity and mortality.

Original languageEnglish
Pages (from-to)2894-2901
Number of pages8
JournalWorld journal of surgery
Volume42
Issue number9
DOIs
Publication statusPublished - Sep 1 2018

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All Science Journal Classification (ASJC) codes

  • Surgery

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