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Impact of the Ratio of Visceral Fat Area (VFA) to Psoas Muscle Area (PMA) (V/P Ratio) on Survival for Surgically Resected Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The synergic effects of muscle mass reduction with excess body adiposity in surgically resected esophageal cancer (EC) patients remains controversial, especially in non-obese patients.

Methods

One hundred and six patients with EC who underwent surgery between 2006 and 2014 were included in this study. Reduction in muscle mass and excess body adiposity were defined as the ratio of visceral fat area (VFA) to psoas muscle area (PMA) (V/P ratio) on the same axial computed tomography (CT) slice at the third lumbar vertebra (L3).

Results

A high V/P ratio was associated with greater age (p = 0.03), higher body mass index (BMI) (p < 0.001), higher VFA (p < 0.001), and increased age-adjusted Charlson comorbidity index (ACCI) (p = 0.005). Multivariate analysis revealed a high V/P ratio to be an independent prognostic factor for poor overall survival (OS) in EC patients who underwent surgery (p = 0.003). The prognostic value of the V/P ratio was still significant in EC patients with a BMI < 25.

Conclusions

A high V/P ratio was associated with poor survival in surgically resected EC patients, even in non-obese patients. The V/P ratio as a surrogate marker of relative muscle mass reduction and fat accumulation may have prognostic value in EC patients regardless of body composition differences.

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Authors and Affiliations

  1. Division of Gastroenterological Surgery, Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan

    Makoto Sakai MD, PhD, Makoto Sohda MD, PhD, Shintaro Uchida MD, Arisa Yamaguchi MD, Takayoshi Watanabe MD, Hideyuki Saito MD, Yasunari Ubukata MD, PhD, Nobuhiro Nakazawa MD, PhD, Kengo Kuriyama MD, PhD, Akihiko Sano MD, PhD, Hiroomi Ogawa MD, PhD & Hiroshi Saeki MD, PhD

  2. Initiative for Advanced Research, Gunma University, Maebashi, Gunma, Japan

    Takehiko Yokobori MD, PhD

  3. Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan

    Ken Shirabe MD, PhD

Authors
  1. Makoto Sakai MD, PhD
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  2. Makoto Sohda MD, PhD
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Corresponding author

Correspondence to Makoto Sohda MD, PhD.

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Supplementary Information

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Supplementary Fig. 1.

Kaplan–Meier curves for cancer-specific survival according to the V/P ratio (PPTX 79 kb)

Supplementary Fig. 2.

Kaplan–Meier curves for disease-free survival according to the V/P ratio (PPTX 77 kb)

Supplementary Fig. 3.

Kaplan–Meier curves for overall survival in patients who were underweight (BMI < 19) according to the V/P ratio (PPTX 73 kb)

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Sakai, M., Sohda, M., Uchida, S. et al. Impact of the Ratio of Visceral Fat Area (VFA) to Psoas Muscle Area (PMA) (V/P Ratio) on Survival for Surgically Resected Esophageal Cancer. Ann Surg Oncol 29, 4465–4471 (2022). https://doi.org/10.1245/s10434-022-11497-1

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