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Prognostic Impact of Postoperative Loss of Skeletal Muscle Mass in Patients Aged 70 Years or Older with Esophageal Cancer

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

Abstract

Background

The number of patients with esophageal cancer aged ≥ 70 years with a poor prognosis is increasing. In general patients with esophageal cancer, postoperative loss of skeletal muscle mass (SMM) is a prognostic factor. This study was designed to investigate the prognostic impact of postoperative loss of SMM in patients aged ≥ 70 years with esophageal cancer.

Methods

This study was a single-center, retrospective cohort study. Patients with esophageal cancer who underwent R0 esophagectomy between 2016 and 2020 were included. The percentage postoperative loss of skeletal muscle mass index (SMI%) was calculated using computed tomography images before and at 4 ± 2 months after surgery.

Results

The number of subjects in the ≥ 70-year and < 70-year age groups was 166 and 218, respectively. The median SMI% was 5% in all patients; thus, 5% was defined as the cutoff point to define major loss of SMI. Major loss of SMI impacted 3-year overall survival (OS) in the ≥ 70-year age group, independent of age, sex, clinical stage, pathological T and N factors, Charlson comorbidity index, and length of hospital stay (adjusted hazard ratio [HR]: 4.400; 95% confidence interval: 1.202–16.105; P = 0.025). The adjusted HR of major loss of SMI in the ≥ 70-year age group was higher than in the < 70-year age group (adjusted HR: 4.400 vs. 2.388, respectively).

Conclusions

Postoperative loss of SMI in patients with esophageal cancer aged ≥ 70 years more strongly impacted 3-year OS than in patients aged < 70 years.

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Acknowledgments

The authors thank the members of the Department of Rehabilitation Medicine, Esophageal Surgery, for their support; this research would not have been possible without their cooperation. They also thank Emily Woodhouse, PhD, and Georgia Lenihan-Geels, PhD, from Edanz (https://jp.edanz.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Rehabilitation, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Tsuyoshi Harada MSc, Junya Ueno, Yu Koishihara MSc, Nobuko Konishi MSc, Nanako Hijikata MD, Aiko Ishikawa MD, PhD & Tetsuya Tsuji MD, PhD

  2. Department of Rehabilitation Medicine, Keio University Graduate School, Tokyo, Japan

    Tsuyoshi Harada MSc

  3. Department of Integrated Health Sciences, Nagoya University, Nagoya, Aichi, Japan

    Noriatsu Tatematsu PhD

  4. Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan

    Aiko Ishikawa MD, PhD & Tetsuya Tsuji MD, PhD

  5. Department of Esophageal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Hisashi Fujiwara MD & Takeo Fujita MD, PhD, FACS

Authors
  1. Tsuyoshi Harada MSc
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  2. Noriatsu Tatematsu PhD
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Correspondence to Takeo Fujita MD, PhD, FACS.

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Harada, T., Tatematsu, N., Ueno, J. et al. Prognostic Impact of Postoperative Loss of Skeletal Muscle Mass in Patients Aged 70 Years or Older with Esophageal Cancer. Ann Surg Oncol 29, 5638–5645 (2022). https://doi.org/10.1245/s10434-022-11801-z

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  • DOI: https://doi.org/10.1245/s10434-022-11801-z

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