Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer

Dae Won Ma, Yeona Cho, Mi jin Jeon, Jie Hyun Kim, Ik Jae Lee, Young Hoon Youn, Jae Jun Park, Da Hyun Jung, Hyojin Park, Chang Geol Lee, Jun Won Kim, Hei Cheul Jeung

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Abstract

Background: Sarcopenia, defined as skeletal muscle loss, has been known as a poor prognosis factor in various malignant diseases The aim of this study is to investigate the effect of sarcopenia on prognosis in patients with esophageal cancer who received concurrent chemo- and radiotherapy (CCRT). Methods: We retrospectively collected clinical data of 287 patients with esophageal cancer who were treated by definite CCRT at Gangnam Severance and Severance hospital from August 2005 to December 2014. The cross-sectional area of muscle at the level of the third lumbar vertebra was measured using pre- and post-CCRT computed tomography images. Sarcopenia was defined as skeletal muscle index <49 cm2/m2 for men and of <31 cm2/m2 for women by Korean-specific cutoffs. Overall survival (OS) and progression free survival (PFS) were analyzed according to sarcopenia. Results: Sarcopenia identified before CCRT did not affect OS and PFS. However, patients with post-CCRT sarcopenia showed shorter OS and PFS than patients without it (median OS: 73 months vs. 28 months; median PFS: 34 months vs. 25 months, respectively). Post-CCRT sarcopenia was an independent prognostic factor of poor OS (hazards ratio: 1.697; 95% confidence interval: 1.036–2.780; P = 0.036). In multivariate analysis, male sex (P = 0.004) and presence of CCRT-related complications, such as esophagitis or general weakness were significantly associated with post-CCRT sarcopenia (P = 0.016). Conclusions: Sarcopenia after CCRT can be a useful predictor for long-term prognosis in patients with esophageal cancer. To control CCRT-related complications may be important to prevent skeletal muscle loss during CCRT.

Original languageEnglish
Article number366
JournalFrontiers in Oncology
Volume9
Issue numberMAY
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Ma, D. W., Cho, Y., Jeon, M. J., Kim, J. H., Lee, I. J., Youn, Y. H., Park, J. J., Jung, D. H., Park, H., Lee, C. G., Kim, J. W., & Jeung, H. C. (2019). Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer. Frontiers in Oncology, 9(MAY), [366]. https://doi.org/10.3389/fonc.2019.00366