CT-based assessment of visceral adiposity and outcomes for esophageal adenocarcinoma

Abstract

Background: Various methods of quantifying and correlating obesity to outcomes for patients with esophageal adenocarcinoma (EA) have been evaluated. Published data suggest that quantification of adiposity may be more accurate than body mass index (BMI) as a prognostic factor. We report our analysis of adiposity as a prognostic factor in a series of patients with EA. to −130. Outcomes were analyzed using Kaplan-Meier method and log-rank analysis. Multivariate analysis (MVA) was performed using the Cox proportion hazard regression model. Results:We identified 126 patients for the analysis. There were no statistically significant differences in overall survival or disease-free survival between groups above and below the medians for TFA, SFA, or VFA/SFA ratio. However, an increase in VFA was significantly associated with worsened OS and DFS when we further classified patients into quartiles. Patients with VFA ≥182 cm² had larger tumor size (P=0.016), fewer involved lymph nodes (P=0.047), longer operating times (P=0.032), and were more likely to be males (P=0.042).Conclusions: Published data have demonstrated an association between treatment outcomes and degree of adiposity; our study found a correlation between VFA and OS and DFS in patients with EA. Median TFA, SFA, and VFA/SFA were not prognostic on MVA. While VFA >182 cm 2 was associated with larger tumors, there were also fewer lymph nodes harvested in this group.

Visceral Obesity, Metabolic Syndrome, and Esophageal Adenocarcinoma

“…Sarcopenic obesity however be associated with adverse survival outcomes among patients with esophageal cancer (156). For VA specifically, a solitary study of 126 patients assessed its impact on survival among patients with EAC and reported no impact of visceral obesity above a median, but worsened outcomes with increasing visceral obesity presented in quartiles, principally due to more advanced clinical stage (157).…”

Influence of body composition and muscle strength on outcomes after multimodal oesophageal cancer treatment

“…16 Both sarcopenia and obesity are associated with post-operative morbidity, mortality, and lower overall survival in patients with oesophageal cancer, and it is hypothesized that sarcopenic obesity may have a greater impact than either sarcopenia or obesity alone. [17][18][19][20] It is therefore of importance to evaluate influence of sarcopenia in combination with other body composition parameters and muscle strength on long-term and short-term outcomes in oesophageal cancer patients.…”