PS02.236: THE IMPACT OF PREOPERATIVE SKELETAL MUSCLE MASS ON POSTOPERATIVE OUTCOMES AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract Background It is said that preoperative muscle volume is likely associated with postoperative short- and long-term outcomes in several kinds of cancer by many reports. Esophagectomy for esophageal cancer (EC) is associated with high morbidity and EC has one of the worst prognoses in several kinds of cancer. We investigated the association of preoperative skeletal muscle mass with postoperative outcomes to improve them. Methods We analyzed 150 patients who underwent esophagectomy from February 2002 to March 2016. The cross-sectional area of the psoas muscle index (PMI) was measured at the third lumbar vertebral level using computed tomography. Clavien-Dindo classifications were used to analyze postoperative complications. Since skeletal muscle mass is significantly different according to gender, all analyses were completed by gender (male: 124, female: 26). The Mann-Whitney U test and the chi-square test were used to compare two groups for the analysis of postoperative complications. Multivariate analysis of postoperative complications was performed using a logistic regression model. Survival analyses were performed using a Cox proportional hazard model. Differences were considered to be significant if the P value was less than 0.05. Results In male patients, PMI value was significantly higher in CD≦ II groups than CD≧ III groups. It was also a independent factor for predicting postoperative complications (odds ratio: 0.995, 95% confidence interval: 0.991–0.999, P = 0.02). On the other hand, there was not a significant difference between PMI and overall survival. In female patients, PMI was not associated with postoperative complications and survival. Only pulmonary function (vital capacity percentage) was associated with postoperative complications and survival. Conclusion Preoperative muscle mass was associated with postoperative complications in male patients with EC. In male patients, PMI can be a useful tool to predict postoperative outcomes and select patients who require preoperative nutritional intervention and rehabilitation. Disclosure All authors have declared no conflicts of interest.

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Impact of Low Skeletal Muscle Mass on Complications and Survival for Gastric Cancer: A Propensity Score Matching Analysis

10.21203/rs.3.rs-614857/v1 ◽

2021 ◽

Author(s):

Zhen Fang ◽

Peijuan Li ◽

Jin Liu ◽

Wei Chong ◽

Fengying Du ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Postoperative Complications ◽

Propensity Score ◽

Propensity Score Matching ◽

Muscle Mass ◽

Laparoscopic Gastrectomy ◽

Skeletal Muscle Mass ◽

Significant Difference ◽

The Impact

Abstract Background: Increasing evidence has indicated that low skeletal muscle mass is linked with cancer prognosis, but existing have shown contrasting results. The purpose of the study is to determine the impact of preoperative low skeletal muscle mass (LSMM) on complications and survival of patients who undergo laparoscopic gastrectomy for gastric cancer (GC).Methods: Patients who undergo laparoscopic gastrectomy for GC were enrolled and third lumbar vertebra psoas muscles index (PMI) was assessed by computer tomography (CT). Using propensity score matching (1:1) to obtain 2 well-balanced cohorts for available variables influencing clinical outcomes, comparing the postoperative complications and 3-year overall survival (OS) between LSMM group and non-LSMM group.Results: A total of 386 patients, 226 were matched for analyses. Compared with the non-LSMM group, the LSMM group manifested significantly shorter 3-year OS (58.14% vs 71.95%, P=0.034). However, the incidence of postoperative complications was no difference between two groups after matching. After stratification based on the pT stage of the tumor, statistically significant difference in the 3-year OS rates of the advance GC cohort between the two groups were observed.Conclusions: LSMM predicts a poor prognosis for patients with advance GC and it is not associated with postoperative complications.

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The impact of sarcopenia and decrease in skeletal muscle mass in patients with advanced pancreatic cancer during FOLFIRINOX therapy

British Journal Of Nutrition ◽

10.1017/s0007114520003463 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Shinya Uemura ◽

Takuji Iwashita ◽

Hironao Ichikawa ◽

Yuhei Iwasa ◽

Naoki Mita ◽

...

Keyword(s):

Skeletal Muscle ◽

Pancreatic Cancer ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Tumour Size ◽

Advanced Pancreatic Cancer ◽

Significant Risk ◽

Skeletal Muscle Index ◽

Significant Difference ◽

The Impact

Abstract Sarcopenia, defined as decrease in skeletal muscle mass (SMM) and strength, might be associated with reduced survival. We investigated the impact of sarcopenia and decrease in SMM in patients with advanced pancreatic cancer during FOLFIRINOX (FX) therapy. Consecutive sixty-nine patients who received FX were evaluated. Skeletal muscle index (SMI) (cm2/m2) was used to evaluate SMM. The cut-off value of sarcopenia was defined as SMI <42 for males and <38 for females, based on the Asian Working Group for sarcopenia criteria. Sarcopenia was diagnosed in thirty-three (48 %) subjects. Comparison of baseline characteristics of the two groups (sarcopenia group: non-sarcopenia group) showed a significant difference in sex, tumour size and BMI. There was no significant difference in the incidence of adverse events with grades 3–5 and progression-free survival (PFS) during FX between the two groups (PFS 8·1 and 8·8 months; P = 0·88). On the multivariate analysis, progressive disease at the first follow-up computed tomography (hazard ratio (HR) 3·87, 95 % CI 1·53, 9·67), decreased SMI ≥ 7·9 % in 2 months (HR 4·02, 95 % CI 1·87, 8·97) and carcinoembryonic antigen ≥ 4·6 (HR 2·52, 95 % CI 1·10, 6·11) were significant risk factors associated with poor overall survival (OS), but sarcopenia at diagnosis was not. OS in patients with decreased SMI of ≥7·9 % and <7·9 % were 10·9 and 21·0 months (P < 0·01), respectively. In conclusion, decrease in SMM within 2 months after the initiation of chemotherapy had significantly shorter OS, although sarcopenia at diagnosis did not affect OS. Therefore, it might be important to maintain SMM during chemotherapy for a better prognosis.

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IDDF2020-ABS-0159 A new diagnostic index of skeletal muscle mass for predicting short-term postoperative complications in Crohn’s disease

10.1136/gutjnl-2020-iddf.101 ◽

2020 ◽

Author(s):

Xiaolong Ge ◽

Linna Ye ◽

Qian Cao ◽

Wei Zhou

Keyword(s):

Skeletal Muscle ◽

Crohn’S Disease ◽

Postoperative Complications ◽

Crohn's Disease ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Short Term ◽

Diagnostic Index

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ASO Visual Abstract: Combination of Skeletal Muscle Mass and Density Predicts Postoperative Complications and Survival of Patients with Non-small Cell Lung Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-021-11071-1 ◽

2021 ◽

Author(s):

Changbo Sun ◽

Masaki Anraku ◽

Takuya Kawahara ◽

Takahiro Karasaki ◽

Chihiro Konoeda ◽

...

Keyword(s):

Lung Cancer ◽

Skeletal Muscle ◽

Postoperative Complications ◽

Small Cell Lung Cancer ◽

Muscle Mass ◽

Cell Lung Cancer ◽

Skeletal Muscle Mass ◽

Small Cell ◽

Small Cell Lung

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630 IMPACT OF LOW SKELETAL MUSCLE MASS AND DENSITY ON OUTCOMES OF LOCALLY ADVANCED ESOPHAGEAL CANCER PATIENTS TREATED WITH RADICAL RADIOTHERAPY

Diseases of the Esophagus ◽

10.1093/dote/doab052.630 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Yuan Wang ◽

Ningjing Yang ◽

Hongyuan Jia ◽

Long Liang ◽

Lei Wu ◽

...

Keyword(s):

Skeletal Muscle ◽

Esophageal Cancer ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Mass Density ◽

Locally Advanced ◽

Radical Radiotherapy ◽

Term Survival ◽

Locally Advanced Esophageal Cancer

Abstract Low skeletal muscle mass and density are independent predictors of clinical outcomes in multiple gastrointestinal cancers. However, its effect on the long-term survival of locally advanced esophageal cancer patients undergoing radical radiotherapy is still unclear. Methods Patients with stage II-III esophageal cancer undergoing radical radiotherapy, enrolled in a observational cohort study, were included. Skeletal muscle mass and density were measured on CT. Patients with high and low skeletal muscle mass and density were compared regarding overall survival (OS). Results 165 patients (75.8% males, median age 63) were included, from March-2012 to September-2017. Before radiotherapy, 26.7% patients had low skeletal-muscle-mass and 23.0% patients had low skeletal-muscle-density. After radiotherapy, 40.6% patients had low skeletal-muscle-mass and 30.3% patients had low skeletal-muscle-density.The median OS of high skeletal-muscle-mass/density group was significantly higher than that of low skeletal-muscle-mass/density group before radiotherapy (28.7 vs 28.2 months, p = 0.041; 29.6 vs 16.9 months, p = 0.025). The median OS of high skeletal-muscle-mass/density group was also significantly higher than that of low skeletal-muscle-mass/density group after radiotherapy (30.3 vs 20.3 months, P = 0.012; 29.6 vs 17.2 months, p = 0.018). Conclusion Low skeletal muscle mass and density are associated with long-term outcome in patients undergoing radical radiotherapy. It is suggested that oncologists should pay more attention to the management of muscle mass and density of patients with esophageal cancer undergoing radiotherapy in order to improve their nutritional status and long-term survival.

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Predictors of changes in skeletal muscle mass after esophagectomy in elderly patients with esophageal cancer

10.21203/rs.3.rs-213862/v1 ◽

2021 ◽

Author(s):

Tsuyoshi Harada ◽

Noriatsu Tatematsu ◽

Junya Ueno ◽

Yu Koishihara ◽

Nobuko Konishi ◽

...

Keyword(s):

Skeletal Muscle ◽

Esophageal Cancer ◽

Elderly Patients ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Quadriceps Muscle ◽

Computed Tomography Images ◽

Ratio Change ◽

Comprehensive Rehabilitation ◽

The Mean

Abstract Purpose : Although a change in skeletal muscle mass index (SMI) 4 months after esophagectomy impacts prognosis, predictors of a change in SMI have not been revealed. The purpose of this exploratory retrospective study was to clarify the predictors of a change in SMI after curative esophagectomy in elderly patients with esophageal cancer.Methods : Fifty-four patients who underwent esophagectomy and perioperative rehabilitation from 2015 to 2018 were enrolled. Preoperative and postoperative SMI (cm 2 /m 2 ) were calculated using computed tomography images. The ratio change in SMI was calculated as follows: (postoperative SMI − preoperative SMI) ÷ preoperative SMI × 100%. Potential predictors of a change in SMI ratio were analyzed by multiple regression. Results : The mean ratio change in SMI 4 months after esophagectomy was −7.1% ± 9.4%. The ratio change in quadriceps muscle strength in the first month after surgery ([postoperative strength − preoperative strength] ÷ preoperative strength × 100%) (standardized β = .273, p = .038) and neoadjuvant chemotherapy (NAC) (standardized β = .398, p = .006) were predictors of the ratio change in SMI independent of age, sex, pathological stage, and preoperative SMI. Conclusion : Quadriceps muscle weakness in the first month after esophagectomy and NAC were predictors of the ratio change in SMI after esophagectomy. Continuous postoperative comprehensive rehabilitation and supportive care may inhibit loss of skeletal muscle mass.

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