Impact of early postoperative factors on changes in skeletal muscle mass after esophagectomy in older patients with esophageal cancer

Harada, Tsuyoshi; Tatematsu, Noriatsu; Ueno, Junya; Koishihara, Yu; Konishi, Nobuko; Fukushima, Takuya; Fujiwara, Hisashi; Fujita, Takeo; Hijikata, Nanako; Wada, Akira; Ishikawa, Akio; Tsuji, Takao

doi:10.1007/s41999-022-00735-0

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Terefore, in older patients with esophageal cancer, postoperative progression of frailty with SMM 4 months after surgery may impact the recovery status of SMM 12 months after surgery independent of preoperative characteristics. Te most recent study reported that the loss of SMI 4 months after surgery was afected by the decline in quadriceps muscle strength in the frst month after surgery in older patients with esophageal cancer [37]. Additionally, a previous study reported that esophageal cancer patients with low physical activity after discharge had a higher percentage loss of SMM 6 months after surgery than those with high physical activity [38].…”

Section: Discussionmentioning

confidence: 98%

The Postoperative Recovery Course of Skeletal Muscle Mass in Older Esophageal Cancer Patients

Harada

Tsuji

Tatematsu

et al. 2023

European Journal of Cancer Care

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Purpose. Skeletal muscle mass (SMM) is an important biomarker for health in older cancer patients. However, there is limited information on the recovery course of SMM after esophagectomy in older patients. This study aimed to investigate the recovery course of SMM after esophagectomy and the predictors in older cancer patients. Methods. We conducted a single-center, retrospective cohort study. Esophageal cancer patients who underwent esophagectomy were included. The skeletal muscle mass index (SMI) was calculated using computed tomography images. The loss of SMI at 4 and 12 months after surgery was calculated as [(preoperative − postoperative SMI) ÷ preoperative SMI] × 100%. Nonrecovery was defined as an SMI loss of ≥2% at 12 months after surgery, considering physiological loss with aging. One-way analysis of variance and multivariate logistic regression analysis was used for statistical analysis. Results. A total of 105 older (≥70 years) and 156 nonolder (<70 years) patients were analyzed. Older patients had a significantly larger loss of SMI 4 months (mean: 5.7% vs. 3.1%; p = 0.021 ) and 12 months (mean: 1.0% vs. −1.4%; p = 0.040 ) after surgery than nonolder patients. In older patients, the number of patients with nonrecovery of SMI at 12 months after surgery was 55 (52%). In older patients, significant predictors for the nonrecovery of SMI were preoperative sarcopenia (adjusted OR: 0.297; p = 0.012 ), neoadjuvant chemotherapy (adjusted OR: 0.248; p = 0.015 ), and loss of SMI 4 months after surgery (per 1%; adjusted OR: 1.076; p = 0.018 ). Conclusions. It is suggested that older esophageal cancer patients have a larger unmet need for long-term postoperative loss of SMM than nonolder patients. Continuous outpatient rehabilitation, including exercise and nutritional therapy after discharge, which targets improvement in SMM at 4 months, may improve SMI at 12 months after surgery in older esophageal cancer patients.

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Section: Discussionmentioning

confidence: 98%