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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

Fingerprint

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

Cite this

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.
@article{f1a181688fb84e70a9fea727d7a0356f,
title = "Relationship between sarcopenia and prognosis in patient with concurrent chemo-radiation therapy for esophageal cancer",
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 Kim, {Jie Hyun} 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}",
year = "2019",
month = "1",
day = "1",
doi = "10.3389/fonc.2019.00366",
language = "English",
volume = "9",
journal = "Frontiers in Oncology",
issn = "2234-943X",
publisher = "Frontiers Media S. A.",
number = "MAY",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=85067663189&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067663189&partnerID=8YFLogxK

U2 - 10.3389/fonc.2019.00366

DO - 10.3389/fonc.2019.00366

M3 - Article

AN - SCOPUS:85067663189

VL - 9

JO - Frontiers in Oncology

JF - Frontiers in Oncology

SN - 2234-943X

IS - MAY

M1 - 366

ER -