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Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

Abstract

Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 % ± 6.4 (SD) in comparison to FM index (-1.2 ± 4.2), FFM index (-4.6 ± 6.8), FMR (-1.2 ± 24.3) and VA/SA (-62.3 ± 12.7). Changes in FM index (p = 0.022), FMR (p = 0.028), VA/SA (p = 0.024) and weight (p = 0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Loss of FM, differential  More>>
Authors:
Yip, Connie; [1]  National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore); Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom)]; Goh, Vicky; [1]  Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)]; Davies, Andrew; Gossage, James; Mason, Robert; [2]  Mitchell-Hay, Rosalind; Griffin, Nyree; [3]  Hynes, Orla; [4]  Maisey, Nick; Ross, Paul; Gaya, Andrew; [5]  Landau, David B.; [1]  Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)]; Cook, Gary J. [1] 
  1. King's College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)
  2. Guy's and St Thomas' NHS Foundation Trust, Department of Upper Gastrointestinal and General Surgery, London (United Kingdom)
  3. Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)
  4. Department of Dietetics, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)
  5. Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)
Publication Date:
May 15, 2014
Product Type:
Journal Article
Resource Relation:
Journal Name: European Radiology; Journal Volume: 24; Journal Issue: 5
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADIPOSE TISSUE; CARCINOMAS; CHEMOTHERAPY; COMPUTERIZED TOMOGRAPHY; DOSE-RESPONSE RELATIONSHIPS; ESOPHAGUS; MULTIVARIATE ANALYSIS; PATHOLOGICAL CHANGES; REGRESSION ANALYSIS; SURGERY; SURVIVAL CURVES; SURVIVAL TIME
OSTI ID:
22245269
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0938-7994; CODEN: EURAE3; TRN: DE14F2525066402
Availability:
Available from: http://dx.doi.org/10.1007/s00330-014-3110-4
Submitting Site:
DE
Size:
page(s) 998-1005
Announcement Date:
Jul 08, 2014

Citation Formats

Yip, Connie, National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore), Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom)], Goh, Vicky, Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], Davies, Andrew, Gossage, James, Mason, Robert, Mitchell-Hay, Rosalind, Griffin, Nyree, Hynes, Orla, Maisey, Nick, Ross, Paul, Gaya, Andrew, Landau, David B., Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], and Cook, Gary J. Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer. Germany: N. p., 2014. Web. doi:10.1007/S00330-014-3110-4.
Yip, Connie, National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore), Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom)], Goh, Vicky, Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], Davies, Andrew, Gossage, James, Mason, Robert, Mitchell-Hay, Rosalind, Griffin, Nyree, Hynes, Orla, Maisey, Nick, Ross, Paul, Gaya, Andrew, Landau, David B., Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], & Cook, Gary J. Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer. Germany. https://doi.org/10.1007/S00330-014-3110-4
Yip, Connie, National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore), Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom)], Goh, Vicky, Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], Davies, Andrew, Gossage, James, Mason, Robert, Mitchell-Hay, Rosalind, Griffin, Nyree, Hynes, Orla, Maisey, Nick, Ross, Paul, Gaya, Andrew, Landau, David B., Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], and Cook, Gary J. 2014. "Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer." Germany. https://doi.org/10.1007/S00330-014-3110-4.
@misc{etde_22245269,
title = {Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer}
author = {Yip, Connie, National Cancer Centre, Department of Radiation Oncology, Singapore (Singapore), Imaging 2, Level 1, Lambeth Wing, St Thomas' Hospital, London (United Kingdom)], Goh, Vicky, Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], Davies, Andrew, Gossage, James, Mason, Robert, Mitchell-Hay, Rosalind, Griffin, Nyree, Hynes, Orla, Maisey, Nick, Ross, Paul, Gaya, Andrew, Landau, David B., Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London (United Kingdom)], and Cook, Gary J.}
abstractNote = {Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 % ± 6.4 (SD) in comparison to FM index (-1.2 ± 4.2), FFM index (-4.6 ± 6.8), FMR (-1.2 ± 24.3) and VA/SA (-62.3 ± 12.7). Changes in FM index (p = 0.022), FMR (p = 0.028), VA/SA (p = 0.024) and weight (p = 0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. (orig.)}
doi = {10.1007/S00330-014-3110-4}
journal = []
issue = {5}
volume = {24}
journal type = {AC}
place = {Germany}
year = {2014}
month = {May}
}