論文

査読有り 国際誌
2021年6月11日

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

Cancers
  • Uli Fehrenbach
  • ,
  • Tilo Wuensch
  • ,
  • Pia Gabriel
  • ,
  • Laura Segger
  • ,
  • Takeru Yamaguchi
  • ,
  • Timo Alexander Auer
  • ,
  • Nick Lasse Beetz
  • ,
  • Christian Denecke
  • ,
  • Dino Kröll
  • ,
  • Jonas Raakow
  • ,
  • Sebastian Knitter
  • ,
  • Sascha Chopra
  • ,
  • Peter Thuss-Patience
  • ,
  • Johann Pratschke
  • ,
  • Bernd Hamm
  • ,
  • Matthias Biebl
  • ,
  • Dominik Geisel

13
12
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3390/cancers13122921

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: 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 cm2/m2 in women and ≤52.4 cm2/m2 in men. Patients with a body mass index (BMI) of ≥30 were considered obese. These imaging biomarkers were correlated with major complications, anastomotic leakage, postoperative pneumonia, duration of postoperative hospitalization, disease-free survival (DFS), and overall survival (OS). 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, p = 0.048) and prolonged hospitalization (32 d vs. 19 d, p = 0.040). Patients with sarcopenic obesity had a significantly higher risk for postoperative pneumonia (OR: 6.364 p = 0.018) and a longer postoperative hospital stay (71 d vs. 24 d, p = 0.021). Neither sarcopenia nor sarcopenic obesity was an independent risk factor for the occurrence of anastomotic leakage (p > 0.05). Low preoperative muscle biomarkers (PMA and PMV) and their decrease (ΔPMV and ΔTAMA) during the follow-up period significantly correlated with shorter DFS and OS (p = 0.005 to 0.048). CONCLUSION: 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.

リンク情報
DOI
https://doi.org/10.3390/cancers13122921
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34208070
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8230687
ID情報
  • DOI : 10.3390/cancers13122921
  • PubMed ID : 34208070
  • PubMed Central 記事ID : PMC8230687

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