Loss of skeletal muscle mass during neoadjuvant treatments correlates with worse prognosis in esophageal cancer: a retrospective cohort study
Loss of skeletal muscle mass during neoadjuvant treatments correlates with worse prognosis in esophageal cancer: a retrospective cohort study
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DOI：
10.1186/s12957-018-1327-4
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发表时间：
2018-02-12
影响因子：
3.2
通讯作者：
Rasanen, Jari
中科院分区：
文献类型：
--
作者：
Jarvinen, Tommi;Ilonen, Ilkka;Rasanen, Jari
背景：营养不良、恶病质和肌肉减少症在食管癌中极为常见。本文旨在评估新辅助治疗期间骨骼肌质量丢失对食管癌患者预后的影响。方法：从我们的手术数据库中筛选出2010年至2014年接受新辅助治疗和手术的食管癌患者（N = 115），并进行回顾性分析。在第三腰椎水平测量的总横截面肌肉组织的计算机断层扫描成像定义了骨骼肌指数，该指数定义了肌肉减少症（男性SMI < 52.4 cm 2/m2，女性< 38.5 cm 2/m2）。结果：92例（80%）患者术前影像学检查中出现肌减少。中位总生存期为900天（四分位距334-1447），肌肉减少组（中位数= 900）和非肌肉减少组（中位数= 914）之间无差异（p = 0.872）。并发症发生率无差异（26.1% vs 32.6%，p = 0.725）。新辅助治疗期间骨骼肌指数下降2.98%与2年生存率差相关（对数秩p = 0.04）。结论：新辅助治疗期间骨骼肌组织丢失与总生存率差相关。
Background: Nutritional deficits, cachexia, and sarcopenia are extremely common in esophageal cancer. The aim of this article was to assess the effect of loss of skeletal muscle mass during neoadjuvant treatment on the prognosis of esophageal cancer patients.Methods: Esophageal cancer patients (N = 115) undergoing neoadjuvant therapy and surgery between 2010 and 2014 were identified from our surgery database and retrospectively analyzed. Computed tomography imaging of the total cross-sectional muscle tissue measured at the third lumbar level defined the skeletal muscle index, which defined sarcopenia (SMI < 52.4 cm2/m2 for men and < 38.5 cm2/m2 for women). Images were collected before and after neoadjuvant treatments.Results: Sarcopenia in preoperative imaging was prevalent in 92 patients (80%). Median overall survival was 900 days (interquartile range 334-1447) with no difference between sarcopenic (median = 900) and non-sarcopenic (median = 914) groups (p = 0.872). Complication rates did not differ (26.1% vs 32.6%, p = 0.725). A 2.98% decrease in skeletal muscle index during neoadjuvant treatment correlated with poor 2-year survival (log-rank p = 0.04).Conclusion: Loss of skeletal muscle tissue during neoadjuvant treatment correlates with worse overall survival.