SARCOPENIA AND MYOSTEATOSIS AT PRESENTATION ADVERSELY AFFECT SURVIVAL AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

  • Matevž Srpčič Department of thoracic surgery UKC Lljubljana http://orcid.org/0000-0001-9936-3706
  • Taja Jordan Institute of radiology, University medical centre Ljubljana, Slovenia
  • Karteek Popuri Simon Fraser University, Burnaby, Canada
  • Mihael Sok Department of thoracic surgery, Surgical clinic, University medical centre Ljubljana, Slovenia

Abstract

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.

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%. Both were associated with decreased overall survival. 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=0,043) and 19,0 months (CI 13,3-24,7) vs. 57,1 months (CI 15,2-99,0) for myosteatosis (log rank p=0,045). A relationship between sarcopenia and myosteatosis and negative outcomes after esophagectomy could not be established.

Conclusions: Sarcopenia and myosteatosis before esophagectomy are poor prognostic factors for overall survival but not for perioperative complications. Identification of patients at risk can guide therapeutic decisions and interventions aimed at replenishing muscle reserves.

Keywords: sarcopenia, myosteatosis, esophagectomy, survival, esophageal cancer, muscle depletion
Published
2020-05-31
How to Cite
Srpčič, M., Jordan, T., Popuri, K., & Sok, M. (2020). SARCOPENIA AND MYOSTEATOSIS AT PRESENTATION ADVERSELY AFFECT SURVIVAL AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER. Radiology and Oncology, 54(2), 237-246. Retrieved from https://www.radioloncol.com/index.php/ro/article/view/3387
Section
Clinical oncology