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 Jan 1

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Sarcopenia
Esophageal Neoplasms
Radiotherapy
Drug Therapy
Disease-Free Survival
Survival
Skeletal Muscle
Lumbar Vertebrae
Esophagitis
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Ma, Dae Won ; Cho, Yeona ; Jeon, Mi jin ; Kim, Jie-Hyun ; Lee, Ik Jae ; Youn, Young Hoon ; Park, Jae Jun ; Jung, Da Hyun ; Park, HyoJin ; Lee, Chang Geol ; Kim, Jun Won ; Jeung, Hei Cheul. / Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer. In: Frontiers in Oncology. 2019 ; Vol. 9, No. MAY.
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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.",
author = "Ma, {Dae Won} and Yeona Cho and Jeon, {Mi jin} and Jie-Hyun Kim and Lee, {Ik Jae} and Youn, {Young Hoon} and Park, {Jae Jun} and Jung, {Da Hyun} and HyoJin Park and Lee, {Chang Geol} and Kim, {Jun Won} and Jeung, {Hei Cheul}",
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Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer. / Ma, Dae Won; Cho, Yeona; Jeon, Mi jin; Kim, Jie-Hyun; Lee, Ik Jae; Youn, Young Hoon; Park, Jae Jun; Jung, Da Hyun; Park, HyoJin; Lee, Chang Geol; Kim, Jun Won; Jeung, Hei Cheul.

In: Frontiers in Oncology, Vol. 9, No. MAY, 366, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer

AU - Ma, Dae Won

AU - Cho, Yeona

AU - Jeon, Mi jin

AU - Kim, Jie-Hyun

AU - Lee, Ik Jae

AU - Youn, Young Hoon

AU - Park, Jae Jun

AU - Jung, Da Hyun

AU - Park, HyoJin

AU - Lee, Chang Geol

AU - Kim, Jun Won

AU - Jeung, Hei Cheul

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

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