Sarcopenia: An important prognostic factor for males treated for a locally advanced esophageal carcinoma. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: Benadon, Bethsabee; Servagi-Vernat, Stéphanie; Quero, Laurent; Cattan, Pierre; Guillerm, Sophie; Hennequin, Valerie; Aparicio, Thomas; Lourenço, Nelson; Bouché, Olivier; Hennequin, Christophe
• Is Part Of: Digestive and liver disease. Volume 52:Issue 9(2020)
• Page Start: 1047
• Page End: 1052
• Publication Date: 2020-09
• Subjects: Sarcopenia -- Muscle mass -- Esophageal cancer -- Chemoradiotherapy; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2020.04.009
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Introduction: Sarcopenia is a prognostic factor of esophageal carcinoma (EC) before surgery, with less convincing data reported before chemoradiotherapy (CRT). Material and methods: All patients with a locally advanced EC who had been treated with upfront CRT, between 2010 and 2015, were included. The decision of surgery was made after CRT (40–50 Gy). Muscle mass was measured on a single third lumbar vertebra CT-scan slice. Sarcopenia was internationally defined as skeletal muscle index of ≤39cm2/m2 for women and ≤55cm2/m2 for men. Results were additionally analyzed according to clinical parameters, with a cut-off based on the mean skeletal muscle lumbar index (SMI) of the population studied. Results: Overall, 104 patients were included (male: 69%). Mean SMI was 35cm2/m2 for women and 46cm2/m2 for men, with 81% of patients being sarcopenic ( n = 84). The 3-year overall survival (OS) rate, of 34.6%, was not significantly associated with sarcopenia in the whole population. In men, there was, however, a highly significant correlation between SMI and OS ( p = 0.003), which remained significant upon multivariate analysis ( p = 0.02). When using the mean SMI as cut-off, sarcopenia was significantly associated with 3-year OS (43.3% vs. 26.2%, p = 0.02). Conclusion: A high sarcopenia level appears negatively associated with OS in male EC patients treated with upfront CRT.