Sarcopenia is a Predictor of Postoperative Respiratory Complications in Patients with Esophageal Cancer

Ida, Satoshi; Watanabe, Masayuki; Yoshida, Naoya; Baba, Yoshifumi; Umezaki, Naoki; Harada, Kazuto; Karashima, Ryuichi; Imamura, Yu; Iwagami, Shiro; Baba, Hideo

doi:10.1245/s10434-015-4559-3

Cited by 166 publications

(129 citation statements)

References 30 publications

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“…The high incidence of pneumonia in sarcopenic patients may be caused by delayed mobilization, sequential paralytic ileus, dysphagia, or difficulty with clearing the airway after gastrointestinal surgery. Sarcopenia was found to be an independent predictor of postoperative respiratory complications in esophageal cancer patients [37]. In this study, preoperative respiratory function was worse in the sarcopenic group, which might have adverse effects on postoperative respiratory complications.…”

Section: Discussionmentioning

confidence: 55%

Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy

et al. 2015

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Background Malignancy is a secondary cause of sarcopenia, which is associated with impaired cancer treatment outcomes. The aim of this study was to investigate the prevalence of preoperative sarcopenia among elderly gastric cancer patients undergoing gastrectomy and the differences in preoperative dietary intake and postoperative complications between sarcopenic and non-sarcopenic patients. Methods Ninety-nine patients over 65 years of age who underwent gastrectomy for gastric cancer were analyzed. All patients underwent gait and handgrip strength testing, and whole-body skeletal muscle mass was measured using a bioimpedance analysis technique based on the European Working Group on Sarcopenia in Older People (EWGSOP) algorithm for the evaluation of sarcopenia before surgery. Preoperative dietary intake was assessed using a food frequency questionnaire. Results Of these patients, 21 (21.2 %) were diagnosed with sarcopenia. Sarcopenic patients consumed fewer calories and less protein preoperatively (23.9 vs. 27.8 kcal/ kg ideal weight/day and 0.86 vs. 1.04 g/kg ideal weight/-day; P = 0.001 and 0.0005, respectively). Although the overall incidence of postoperative complications was similar in the two groups (57.1 % vs. 35.9 %; P = 0.08), the incidence of severe (Clavien-Dindo grade C IIIa) complications was significantly higher in the sarcopenic group than in the non-sarcopenic group (28.6 % vs. 9.0 %; P = 0.029). In the multivariate analysis, sarcopenia alone was identified as a risk factor for severe postoperative complications (odds ratio, 4.76; 95 % confidence interval, 1.03-24.30; P = 0.046). Conclusions Preoperative sarcopenia as defined by the EWGSOP algorithm is a risk factor for severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy.

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Section: Discussionmentioning

confidence: 55%

Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy

et al. 2015

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“…However, in patients with esophageal squamous cell carcinoma, a high BMI is a predictor of poor prognosis of postoperative survival. Ida et al 65. reported that sarcopenia might be a predictor of pulmonary complications after esophagectomy.…”

Section: Resultsmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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“…In addition, there is significant evidence showing that sarcopenia is independently associated with poor response to cancer therapy in pancreatic (18), breast (19), colorectal (13,20), and renal-cell (21), and hepatic (22) cancer. Sarcopenia carries a high risk of morbidity (23)(24)(25)(26) and confers poor long-term survival after resection of esophageal cancer (27)(28)(29) chemoradiotherapy and esophageal resection cases (7). To our knowledge, our retrospective study is the first report that shows the impact of sarcopenia on patients with unresectable locally advanced esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

Impact of Sarcopenia in Patients with Unresectable Locally Advanced Esophageal Cancer Receiving Chemoradiotherapy

Sato

Kunisaki

Suematsu

et al. 2018

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Sarcopenia is a Predictor of Postoperative Respiratory Complications in Patients with Esophageal Cancer

Abstract: Sarcopenia may be a predictor of pulmonary complications after esophagectomy. Further analysis is needed to clarify whether nutritional intervention improves skeletal muscle mass and thus contributes to reducing postoperative respiratory complications in sarcopenic patients.

Cited by 166 publications

References 30 publications

Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy

Sarcopenia is associated with severe postoperative complications in elderly gastric cancer patients undergoing gastrectomy

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Impact of Sarcopenia in Patients with Unresectable Locally Advanced Esophageal Cancer Receiving Chemoradiotherapy

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