<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0016_s_007_w2aab3b7c51b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Esophageal cancer remains a disease with poor survival and many complications. Measuring muscle mass and quality can identify patients with diminished muscle mass (sarcopenia) and muscle fat infiltration (myosteatosis). We studied the impact of sarcopenia and myosteatosis in resectable esophageal cancer on overall survival and complications.</p></sec><sec id="j_raon-2020-0016_s_008_w2aab3b7c51b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>139 patients received a radical esophagectomy. Skeletal muscle area (SMA) and muscle attenuation (MA) in CT images at L3 level were recorded and groups with and without sarcopenia and myosteatosis were compared for overall survival (OS), perioperative mortality, conduit complications, pleuropulmonary complications, respiratory failure requiring mechanical ventilation and other significant complications.</p></sec><sec id="j_raon-2020-0016_s_009_w2aab3b7c51b1b6b1aab1c16b3Aa"><h3>Results</h3><p>Prevalence of sarcopenia and myosteatosis at presentation was 16.5% and 51.8%, respectively. Both were associated with decreased OS. Median survival was 18.3 months (CI 5.4–31.1) <italic><sub>vs</sub></italic> 31.0 months (CI 7.4–54.6) for sarcopenia/no sarcopenia (log rank p = 0.042) and 19.0 months (CI 13.3–24.7) <italic><sub>vs</sub></italic> 57.1 months (CI 15.2–99.0) for myosteatosis (log rank p = 0.044), respectively. A relationship between sarcopenia and myosteatosis and other negative outcomes after esophagectomy could not be established.</p></sec><sec id="j_raon-2020-0016_s_010_w2aab3b7c51b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>Sarcopenia and myosteatosis before esophagectomy are associated with decreased overall survival but not with more frequent perioperative complications. Identification of patients at risk can guide therapeutic decisions and interventions aimed at replenishing muscle reserves.</p></sec></abstract>

BackgroundEsophageal cancer remains a disease with poor survival and many complications. Measuring muscle mass and quality can identify patients with diminished muscle mass (sarcopenia) and muscle fat infiltration (myosteatosis). We studied the impact of sarcopenia and myosteatosis in resectable esophageal cancer on overall survival and complications.Patients and methods139 patients received a radical esophagectomy. Skeletal muscle area (SMA) and muscle attenuation (MA) in CT images at L3 level were recorded and groups with and without sarcopenia and myosteatosis were compared for overall survival (OS), perioperative mortality, conduit complications, pleuropulmonary complications, respiratory failure requiring mechanical ventilation and other significant complications.ResultsPrevalence of sarcopenia and myosteatosis at presentation was 16.5% and 51.8%, respectively. Both were associated with decreased OS. Median survival was 18.3 months (CI 5.4–31.1) vs 31.0 months (CI 7.4–54.6) for sarcopenia/no sarcopenia (log rank p = 0.042) and 19.0 months (CI 13.3–24.7) vs 57.1 months (CI 15.2–99.0) for myosteatosis (log rank p = 0.044), respectively. A relationship between sarcopenia and myosteatosis and other negative outcomes after esophagectomy could not be established.ConclusionsSarcopenia and myosteatosis before esophagectomy are associated with decreased overall survival but not with more frequent perioperative complications. Identification of patients at risk can guide therapeutic decisions and interventions aimed at replenishing muscle reserves.

Sarcopenia and myosteatosis at presentation adversely affect survival after esophagectomy for esophageal cancer

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundEsophageal cancer remains a disease with poor survival and many complications. Measuring muscle mass and quality can identify patients with...

Sarcopenia and myosteatosis at presentation adversely affect survival after esophagectomy for esophageal cancer

Article Category: Research Article

Published Online: Mar 27, 2020

Page range: 237 - 246

Received: Jan 07, 2020

Accepted: Mar 03, 2020

DOI: https://doi.org/10.2478/raon-2020-0016

© 2020 Matevz Srpcic, Taja Jordan, Karteek Popuri, Mihael Sok, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.