CT Body Composition of Sarcopenia and Sarcopenic Obesity: Predictors of Postoperative Complications and Survival in Patients with Locally Advanced Esophageal Adenocarcinoma.

body composition computed tomography esophageal cancer sarcopenia sarcopenic obesity surgery

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
11 Jun 2021
Historique:
received: 06 05 2021
revised: 06 06 2021
accepted: 08 06 2021
entrez: 2 7 2021
pubmed: 3 7 2021
medline: 3 7 2021
Statut: epublish

Résumé

To assess the impact of body composition imaging biomarkers in computed tomography (CT) on the perioperative morbidity and survival after surgery of patients with esophageal cancer (EC). Eighty-five patients who underwent esophagectomy for locally advanced EC after neoadjuvant therapy between 2014 and 2019 were retrospectively enrolled. Pre- and postoperative CT scans were used to assess the body composition imaging biomarkers (visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA) and volume (PMV), total abdominal muscle area (TAMA)). Sarcopenia was defined as lumbar skeletal muscle index (LSMI) ≤38.5 cm Preoperatively, sarcopenia was identified in 58 patients (68.2%), and sarcopenic obesity was present in 7 patients (8.2%). Sarcopenic patients were found to have an elevated risk for the occurrence of major complications (OR: 2.587, CT body composition imaging biomarkers can identify high-risk patients with locally advanced esophageal cancer undergoing surgery. Sarcopenic patients have a higher risk of major complications, and patients with sarcopenic obesity are more prone to postoperative pneumonia. Sarcopenia and sarcopenic obesity are both subsequently associated with a prolonged hospitalization. Low preoperative muscle mass and its decrease during the postoperative follow-up are associated with lower DFS and OS.

Sections du résumé

BACKGROUND BACKGROUND
To assess the impact of body composition imaging biomarkers in computed tomography (CT) on the perioperative morbidity and survival after surgery of patients with esophageal cancer (EC).
METHODS METHODS
Eighty-five patients who underwent esophagectomy for locally advanced EC after neoadjuvant therapy between 2014 and 2019 were retrospectively enrolled. Pre- and postoperative CT scans were used to assess the body composition imaging biomarkers (visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA) and volume (PMV), total abdominal muscle area (TAMA)). Sarcopenia was defined as lumbar skeletal muscle index (LSMI) ≤38.5 cm
RESULTS RESULTS
Preoperatively, sarcopenia was identified in 58 patients (68.2%), and sarcopenic obesity was present in 7 patients (8.2%). Sarcopenic patients were found to have an elevated risk for the occurrence of major complications (OR: 2.587,
CONCLUSION CONCLUSIONS
CT body composition imaging biomarkers can identify high-risk patients with locally advanced esophageal cancer undergoing surgery. Sarcopenic patients have a higher risk of major complications, and patients with sarcopenic obesity are more prone to postoperative pneumonia. Sarcopenia and sarcopenic obesity are both subsequently associated with a prolonged hospitalization. Low preoperative muscle mass and its decrease during the postoperative follow-up are associated with lower DFS and OS.

Identifiants

pubmed: 34208070
pii: cancers13122921
doi: 10.3390/cancers13122921
pmc: PMC8230687
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Uli Fehrenbach (U)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Tilo Wuensch (T)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Pia Gabriel (P)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Laura Segger (L)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Takeru Yamaguchi (T)

Department of Radiology, Kobe University Graduate School of Medicine, Kobe 6500017, Japan.

Timo Alexander Auer (TA)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
Berlin Institute of Health (BIH), 10178 Berlin, Germany.

Nick Lasse Beetz (NL)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Christian Denecke (C)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Dino Kröll (D)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Jonas Raakow (J)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Sebastian Knitter (S)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Sascha Chopra (S)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Peter Thuss-Patience (P)

Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Johann Pratschke (J)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Bernd Hamm (B)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Matthias Biebl (M)

Department of Surgery, Campus Charité Mitte and Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Dominik Geisel (D)

Department of Radiology, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.

Classifications MeSH