Combining Sarcopenia and [18F] FDGPET/CT Derived Metabolic Parameters in Patients with Adenocarcinoma Esophageal Cancer Might Improve Outcome Prediction

Abstract

Purpose To determine the prognostic value of sarcopenia measurements done on staging [18F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment. Methods Patients with early stage, surgically treated esophageal adenocarcinoma and available pre-treatment PET/CT were included. The standard uptake value (SUV) and SUV normalized by lean body mass (SUL) were recorded. Skeletal muscle index (SMI) was measured at the L3 level on the CT component of the PET/CT. Sarcopenia was defined as SMI < 34.4cm2/m2 in women and < 45.4cm2/m2 in men. Results Of the included 145 patients. 30% were sarcopenic at baseline. On the univariable Cox proportional hazards analysis, ECOG, surgical T and N staging, Lymphovascular Invasion (LVI) positive lymph nodes and sarcopenia were significant prognostic factors concerning RFS, and OS. On multivariable Cox regression analysis, surgical N staging (p = 0.025) and sarcopenia (p = 0.022) remained significant poor prognostic factors for OS and RFS. Combining the clinical parameters with the imaging derived nutritional evaluation of the patient but not metabolic parameters of the tumor showed improved predictive ability for OS and RFS. Conclusion Combining the patients’ imaging derived sarcopenic status with standard clinical data, but not metabolic parameters offered an overall improved prognostic value concerning OS and RFS.

Nanomedicine in Lung Cancer Immunotherapy

“…However, these strategies have various limitations; for instance, although surgery offers the best outcome for cancers detected at early stages, this approach often falls short for cancers detected at late stages which have already spread throughout the body. Furthermore, chemotherapy has low specificity, drug-induced side effects, and drug resistance, and has shown higher cancer relapse rates similar to radiation therapy (Velpurisiva et al, 2017;Doroudian et al, 2020;Niloy et al, 2021;Anconina et al, 2022;Hosseinkazemi et al, 2022). As a result, researchers were encouraged to make use of the human body's own defense system as a tool to fight cancer.…”