The Influence of Pretherapeutic and Preoperative Sarcopenia on Short-Term Outcome after Esophagectomy

By introducing minimally invasive surgery the rate of postoperative morbidity in esophageal cancer patients could be reduced. But esophagectomy is still associated with a relevant risk of postoperative morbidity and mortality. Patients often present with nutritional deficiency and sarcopenia even at time of diagnosis. This study focuses on the influence of skeletal muscle index (SMI) on postoperative morbidity and mortality. Fifty-two patients were included in this study. SMI was measured using computer tomographic images at the time of diagnosis and before surgery. Then, SMI and different clinicopathological and demographic features were correlated with postoperative morbidity. There was no correlation between SMI before neoadjuvant therapy (p = 0.5365) nor before surgery (p = 0.3530) with the short-term postoperative outcome. Regarding cholesterol level before surgery there was a trend for a higher risk of complications with lower cholesterol levels (p = 0.0846). Our findings suggest that a low preoperative SMI does not necessarily predict a poor postoperative outcome in esophageal cancer patients after esophagectomy but that there are many factors that influence the nutritional status of cancer patients. To improve nutritional status, cancer patients at our clinic receive specialized nutritional counselling during neoadjuvant treatment as well as after surgery.

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PS01.170: IMPACT OF MUSCLE MASS, NUTRITIONAL STATUS AND MUSCLE STRENGTH ON OUTCOMES FOLLOWING SURGERY FOR ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.170 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 97-97

Author(s):

Eliza Hagens ◽

Minke Feenstra ◽

Mark I Van Berge Henegouwen ◽

Suzanne Gisbertz

Keyword(s):

Skeletal Muscle ◽

Overall Survival ◽

Esophageal Cancer ◽

Muscle Strength ◽

Nutritional Status ◽

Neoadjuvant Therapy ◽

Cancer Patients ◽

Surface Area ◽

Muscle Function ◽

Skeletal Muscle Index

Abstract Background Muscle function loss and loss of skeletal muscle have been associated with worse outcomes following surgery for malignancies of gastrointestinal origin. The influence on post-operative outcomes and survival after esophageal surgery remains unclear. Primary objectives of this study were to evaluate the incidence of sarcopenia and malnutrition and to evaluate the influence of skeletal muscle surface area and muscle strength on postoperative outcomes and overall survival in esophageal cancer patients. Methods A retrospective cohort study from a prospective database was conducted in patients with resectable esophageal cancer who underwent curative-intent treatment between January 2011 and January 2016. Skeletal muscle surface area was calculated with CT scans at L3 level and corrected for height and weight before start of treatment and in the interval between neoadjuvant treatment and surgery. Muscle strength was evaluated with various tests on muscle functions and lung function tests. Nutritional status was evaluated using BMI. Results 273 Patients were included. There were 4 patients with sarcopenia before neoadjuvant therapy and only one patient with sarcopenia after completion of neoadjuvant therapy. Median skeletal muscle surface area was 78cm2/m2 for men and 61cm2/m2 for woman. Table 1 shows skeletal muscle surface area, muscle strength and BMI in relation to no, minor or major complications. Muscle strength and nutritional status did not have a significant influence on postoperative complications and overall survival. Conclusion Sarcopenia did not occur frequently in this cohort with potentially curable esophageal cancer patients. Muscle function, skeletal muscle index and BMI did not statistically influence post-operative complications or survival. Disclosure All authors have declared no conflicts of interest.

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Short term outcome for colorectal cancer patients undergoing surgery in Tertiary care center in Eastern India

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2020.11.277 ◽

2021 ◽

Vol 47 (2) ◽

pp. e50-e51

Author(s):

Abhitesh Singh ◽

Anshul Jain ◽

Dillip Muduly ◽

Mahesh Sultania ◽

Jyoti Ranjan Swain ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Eastern India ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Colorectal Cancer Patients

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Preoperative evaluation of skeletal muscle mass in the risk assessment for the short‑term outcome of elderly colorectal cancer patients undergoing colectomy

Molecular and Clinical Oncology ◽

10.3892/mco.2018.1607 ◽

2018 ◽

Author(s):

Hiroshi Tamagawa ◽

Toru Aoyama ◽

Kenta Iguchi ◽

Hirohito Fujikawa ◽

Sho Sawazaki ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Assessment ◽

Skeletal Muscle ◽

Cancer Patients ◽

Skeletal Muscle Mass ◽

Preoperative Evaluation ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Colorectal Cancer Patients

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Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma

Future Oncology ◽

10.2217/fon-2020-0181 ◽

2020 ◽

Vol 16 (35) ◽

pp. 2949-2957

Author(s):

Bei Wang ◽

Xiaowen Jiang ◽

Dalong Tian ◽

Wei Geng

Keyword(s):

Esophageal Cancer ◽

High Risk ◽

Enteral Nutrition ◽

Nutritional Status ◽

Cancer Patients ◽

Nutritional Support ◽

Nutritional Assessment ◽

Assessment Tools ◽

Tumor Patients ◽

Selection Of

Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.

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W1664 A Simple Risk Score to Predict Short-Term and Long-Term Outcome in Only Surgically Treated Esophageal Cancer

Gastroenterology ◽

10.1016/s0016-5085(10)64154-6 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-899

Author(s):

Yogesh K. Vashist ◽

Johannes Metze ◽

Asad Kutup ◽

Maximilian Bockhorn ◽

Florian Gebauer ◽

...

Keyword(s):

Esophageal Cancer ◽

Risk Score ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome

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Association Between Preoperative Nutritional Status and Postoperative Outcome in Head and Neck Cancer Patients

Nutrition and Cancer ◽

10.1080/01635581.2017.1285406 ◽

2017 ◽

Vol 69 (3) ◽

pp. 464-469 ◽

Cited By ~ 21

Author(s):

John S. L. Leung ◽

Alfred Seto ◽

George K. H. Li

Keyword(s):

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Postoperative Outcome

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Preoperative functional health status is a predictor of short-term postoperative morbidity and mortality after bariatric surgery

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2019.02.004 ◽

2019 ◽

Vol 15 (4) ◽

pp. 608-614

Author(s):

Kathleen L. Lak ◽

Melissa C. Helm ◽

Rana M. Higgins ◽

Tammy L. Kindel ◽

Jon C. Gould

Keyword(s):

Bariatric Surgery ◽

Health Status ◽

Postoperative Morbidity ◽

Morbidity And Mortality ◽

Functional Health ◽

Functional Health Status ◽

Short Term

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The role of surgery type in postoperative atrial fibrillation and in-hospital mortality in esophageal cancer patients with preserved left ventricular ejection fraction

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02011-6 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Laite Chen ◽

Lu Zhang ◽

Lu Shi ◽

Guosheng Fu ◽

Chenyang Jiang

Keyword(s):

Atrial Fibrillation ◽

Esophageal Cancer ◽

Hospital Mortality ◽

Cancer Patients ◽

Left Ventricular ◽

Postoperative Atrial Fibrillation ◽

Left Ventricular Ejection ◽

Short Term ◽

Term Survival ◽

Ventricular Ejection Fraction

Abstract Background Postoperative atrial fibrillation (POAF) is one of the most common complications of esophagectomy, which may extend the inpatient hospital stay. Minimally invasive esophagectomy (MIE) has been increasingly used in clinical practice; however, its POAF risk and short-term mortality remain unclear. This study aimed to examine the POAF risk and in-hospital mortality rate between patients receiving MIE and open esophagectomy (OE). Methods Esophageal cancer patients who underwent MIE or OE from a retrospective cohort study were evaluated. A multivariate logistic regression model was built to assess the associations between esophagectomy (MIE vs. OE) and various outcomes (POAF, in-hospital mortality). Covariates included age, sex, body mass index, neoadjuvant therapy, tumor stage, surgery incision type, comorbidities, cardia conditions, peri-operative medication, and complications. Results Of the 484 patients with esophageal cancer, 63 received MIE. A total of 53 patients developed POAF. Compared to patients receiving OE, MIE patients had 81% reduced odds of POAF (adjusted odds ratio [aOR] 0.185, 95% CI 0.039–0.887, P = 0.035). No statistically significant association was found for in-hospital mortality (aOR 0.709, 95% CI 0.114–4.409, P = 0.712). Conclusions MIE is associated with a lower risk of POAF, compared to traditional surgery. No significant short-term survival benefit was found for MIE.

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