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.
Background
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.
Patients and methods
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.
Results
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)
Conclusions
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.