Prognostic Impact of Postoperative Loss of Skeletal Muscle Mass in Patients Aged 70 Years or Older with Esophageal Cancer

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

doi:10.1245/s10434-022-11801-z

Cited by 7 publications

(11 citation statements)

References 39 publications

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“…In a recent meta-analysis, comprehensive rehabilitation, such as exercise therapy with protein supplementation, for older adults with risk of sarcopenia and frailty was reported to improve muscle strength and skeletal muscle mass [ 30 ]. In addition, the mechanism of the prognostic impact of postoperative loss of SMI was suggested to be associated with progression of frailty [ 7 ]. Considering our findings and previous studies, we hypothesize that in older patients with EC, continuous postoperative comprehensive rehabilitation, including exercise and nutrition therapy after perioperative rehabilitation, may prevent the loss of skeletal muscle mass and progression of frailty after esophagectomy by improving muscle strength.…”

Section: Discussionmentioning

confidence: 99%

“…Explanatory variables were potential factors with a p < 0.2 in the univariate analysis. Subsequently, age, sex, preoperative SMI [ 7 ], pT, pN [ 6 ], histological type [ 18 ], CCI [ 10 ], and NAC [ 19 ] were selected as potential preoperative confounding variables. The characteristics of the significant postoperative factors in the multiple linear regression were analyzed using a one-way analysis of variance or χ 2 test.…”

Section: Methodsmentioning

confidence: 99%

“…In older patients with cancer, skeletal muscle mass is an important prognostic factor [ 4 , 5 ]. It was recently reported that in older patients with EC, a change in skeletal muscle mass 4 months after surgery is an important factor for overall survival independent of preoperative skeletal muscle mass [ 6 , 7 ]. Additionally, the previous study also showed that the association between postoperative change in skeletal muscle mass (per 1%) and overall survival in older patients with EC had a strong dose-dependent relationship [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…It was recently reported that in older patients with EC, a change in skeletal muscle mass 4 months after surgery is an important factor for overall survival independent of preoperative skeletal muscle mass [ 6 , 7 ]. Additionally, the previous study also showed that the association between postoperative change in skeletal muscle mass (per 1%) and overall survival in older patients with EC had a strong dose-dependent relationship [ 7 ]. Although preoperative factors, including pathological tumor stage and preoperative skeletal muscle mass, impacted postoperative changes in skeletal muscle mass in previous studies [ 6 , 7 ], to our knowledge, no studies have investigated the impact of early postoperative factors on postoperative changes in skeletal muscle mass.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, the previous study also showed that the association between postoperative change in skeletal muscle mass (per 1%) and overall survival in older patients with EC had a strong dose-dependent relationship [ 7 ]. Although preoperative factors, including pathological tumor stage and preoperative skeletal muscle mass, impacted postoperative changes in skeletal muscle mass in previous studies [ 6 , 7 ], to our knowledge, no studies have investigated the impact of early postoperative factors on postoperative changes in skeletal muscle mass. Changes in skeletal muscle mass are associated with reversible factors, such as physical function and nutrition, and irreversible factors, such as disease and aging, in older adults [ 4 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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Background Loss of skeletal muscle mass, measured by the skeletal muscle mass index (SMI), after esophagectomy negatively impacts prognosis. However, the information to develop novel supportive care options for preventing loss of skeletal muscle mass is limited. The purpose of this retrospective cohort study was to investigate the impact of early postoperative factors on change in SMI 4 months after curative esophagectomy in older patients with esophageal cancer. Methods This study included 113 subjects who underwent esophagectomy between 2015 and 2020. Preoperative and postoperative SMI (cm2/m2) were calculated from computed tomography images. The percentage change in SMI 4 months after surgery (SMI%) was calculated as follows: ([postoperative SMI – preoperative SMI] ÷ preoperative SMI) × 100. Potential factors affecting percentage change of SMI after surgery were analyzed by multiple regression. Results The mean SMI% was – 5.6%. The percentage change (per 1%) in quadriceps muscle strength in the first month after surgery (standardized β = 0.190, p = 0.048) impacted the SMI%, which was independent of age, sex, preoperative SMI, comorbidity, pathological stage, and neoadjuvant chemotherapy. Conclusion Quadriceps muscle weakness in the first month after esophagectomy impacted the SMI% in a dose-dependent relationship.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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Systemic inflammation score as a predictor of death within one year after esophagectomy

Sato,

Nakatani,

Hawke

et al. 2024

Esophagus

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Low Muscle Mass and Radiodensity Associate with Impaired Pulmonary Function and Respiratory Complications in Patients with Esophageal Cancer

Cameron

Ayzengart

Oduntan

et al. 2023

Journal of the American College of Surgeons

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BACKGROUND: Sixty percent of patients with esophageal cancer display signs of cachexia at diagnosis. Changes in body composition are common, and muscle mass and quality are measurable through imaging studies. Cachexia leads to functional impairments that complicate treatments, including surgery. We hypothesize that low muscle mass and quality associate with pulmonary function testing parameters, highlighting ventilatory deficits, and postoperative complications in patients receiving esophagectomy. STUDY DESIGN: We performed a retrospective review of patients receiving esophagectomy between 2012 and 2021 at our facility. PET/CT scans were used to quantify skeletal muscle at the L3 and T4 levels. Patient characteristics were recorded, including pulmonary function testing parameters. Regression models were created to characterize predictive associations. RESULTS: One hundred eight patients were identified. All were included in the final analysis. In linear regression adjusted for sex, age, and COPD status, low L3 muscle mass independently associated with low forced vital capacity (p < 0.005, β 0.354) and forced expiratory volume in 1 second (p < 0.001, β 0.392). Similarly, T4 muscle mass independently predicted forced vital capacity (p < 0.005, β 0.524) and forced expiratory volume in 1 second (p < 0.01, β 0.480). L3 muscle quality correlated with total lung capacity (R 0.2463, p < 0.05). Twenty-six patients had pleural effusions postoperatively, associated with low muscle quality on L3 images (p < 0.05). Similarly, patients with hospitalization more than 2 weeks presented with lower muscle quality (p < 0.005). CONCLUSIONS: Cachexia and low muscle mass are common. Reduced muscle mass and quality independently associate with impaired forced vital capacity, forced expiratory volume in 1 second, and total lung capacity. We propose that respiratory muscle atrophy occurs with weight loss. Body composition analyses may aid in stratifying patients. Pulmonary function testing may also serve as a functional endpoint for clinical trials. These findings highlight the need to study mechanisms that lead to respiratory muscle pathology and dysfunction in tumor-bearing hosts.

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Prognostic Impact of Postoperative Loss of Skeletal Muscle Mass in Patients Aged 70 Years or Older with Esophageal Cancer

Cited by 7 publications

References 39 publications

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

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

Systemic inflammation score as a predictor of death within one year after esophagectomy

Low Muscle Mass and Radiodensity Associate with Impaired Pulmonary Function and Respiratory Complications in Patients with Esophageal Cancer

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