Prognostic Impact of Sarcopenic Obesity after Neoadjuvant Chemotherapy Followed by Surgery in Elderly Patients with Esophageal Squamous Cell Carcinoma
| Autor: | Yasumasa Niwa, Yoshitaka Inaba, Eiji Higaki, Masahito Shimizu, Masahiro Tajika, Tetsuya Abe, Keisaku Yamada, Takahiro Hosoi, Kei Muro, Tsutomu Tanaka, Sachiyo Onishi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment lcsh:Medicine Malignancy Article 03 medical and health sciences 0302 clinical medicine Weight loss medicine Sarcopenic obesity sarcopenia obesity Adverse effect Chemotherapy business.industry Hazard ratio lcsh:R Cancer General Medicine medicine.disease Surgery elderly patient esophageal squamous cell carcinoma 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology medicine.symptom business Body mass index neoadjuvant chemotherapy |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 9 Journal of Clinical Medicine, Vol 9, Iss 2974, p 2974 (2020) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9092974 |
| Popis: | We evaluated the impact of body composition on clinical outcomes after neoadjuvant chemotherapy (NAC) followed by surgery for elderly cStage II/III esophageal squamous cell carcinoma (ESCC). Ninety-one patients &ge 70 years old and 116 patients < 70 years old with ECSS who underwent NAC between January 2013 and June 2018 at the Aichi Cancer Center were included. Body composition as assessed from computed tomography (CT), American Society of Anesthesiologists physical status (ASA-PS), and subjective global assessment (SGA) was assessed before initiation of NAC. Although elderly patients showed significantly poorer ASA-PS (p < 0.01) and SGA (p < 0.01), and significantly more frequent history of malignancy (p < 0.05), no significant differences were identified in the frequencies of adverse events, postoperative complications, or in cancer-specific survival (p = 0.65, hazard ratio 1.15), or overall survival (p = 0.42, hazard ratio 1.26). However, multivariate analysis identified sarcopenic obesity as the only independent predictor of prognosis in elderly patients. Sarcopenic obesity was associated with higher body mass index (p = 0.04), better SGA (p < 0.01), and lower pre-treatment weight loss (p = 0.03). NAC was as effective and safe for elderly patients without sarcopenic obesity as for young patients. However, diagnosing sarcopenic obesity based on clinical findings is difficult, so the preoperative CT assessment of sarcopenic obesity is important. |
| Databáze: | OpenAIRE |
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