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The impact of sarcopenia on pathologic complete response following neoadjuvant chemoradiation in rectal cancer

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Abstract

Purpose

The role of sarcopenia in pathologic complete response (pCR) following neoadjuvant chemoradiotherapy (nCRT) in non-metastatic locally advanced rectal cancer is currently unknown. The present study investigates the association between sarcopenia and post-nCRT pCR.

Methods

The data of patients operated on following nCRT between January 2013 and January 2020 were collected retrospectively. Sarcopenia was diagnosed based on the calculation of the skeletal muscle index (SMI) from computed tomography carried out at the time of the initial diagnosis. A statistical analysis was then conducted for predictors of pCR.

Results

The study included 61 patients with an average age of 57.3 years, 28 of whom formed the non-sarcopenic group (NSG) and 33 the sarcopenic group (SG). Of the patients, 32.7% were at clinical stage 2, and 67.3% were at clinical stage 3. Pathologic data following a mesorectal excision revealed a pCR rate of 21.4% in the NSG compared with 3% in the SG, which was a statistically significant difference (p = 0.025). The TNM downstaging rate was higher in the NSG than in the SG, although the difference was not statistically significant (50% vs. 33.3%, p = 0.28). A univariate analysis revealed the factors affecting pCR to be non-sarcopenia (p = 0.025), age < 61 years (p = 0.004), interval to surgery ≥ 8 weeks (p = 0.029), and serum CEA < 2.5 ng/ml (p = 0.035).

Conclusion

Sarcopenia was found to be a negative marker of pCR following nCRT in non-metastatic locally advanced rectal cancer.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kosuyolu Research and Education Hospital, University of Health Sciences, 34865, Istanbul, Turkey

    Tolga Olmez, Cem Batuhan Ofluoglu, Selcuk Gulmez, Aziz Serkan Senger, Orhan Uzun, Mustafa Duman & Erdal Polat

  2. Department of Surgery, Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Ozlem Zeliha Sert

  3. Department of Pathology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

    Sevinc Hallac Keser

Authors
  1. Tolga Olmez
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  2. Cem Batuhan Ofluoglu
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  3. Ozlem Zeliha Sert
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  4. Sevinc Hallac Keser
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  5. Selcuk Gulmez
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  6. Aziz Serkan Senger
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  7. Orhan Uzun
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  8. Mustafa Duman
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  9. Erdal Polat
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Contributions

Study conception and design: TO, CBO, OZS, SHK; acquisition of data: TO, ASS, SG; analysis and interpretation of data: OU, MD, EP; drafting of the manuscript: TO, CBO, MD; critical revision of the manuscript: TO, MD, EP

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Correspondence to Tolga Olmez.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

Yes. The Institutional Review Board (IRB) of our hospital approved this study (approval numbers 2019.6/7-224), which was conducted in accordance with the ethical standards of the Declaration of Helsinki, as revised in 2013.

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Olmez, T., Ofluoglu, C.B., Sert, O.Z. et al. The impact of sarcopenia on pathologic complete response following neoadjuvant chemoradiation in rectal cancer. Langenbecks Arch Surg 405, 1131–1138 (2020). https://doi.org/10.1007/s00423-020-01983-z

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  • DOI: https://doi.org/10.1007/s00423-020-01983-z

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