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Significance of Comprehensive Analysis of Preoperative Sarcopenia Based on Muscle Mass, Muscle Strength, and Physical Function for the Prognosis of Patients with Esophageal Cancer

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

Abstract

Background

The assessment of muscle mass loss, muscle strength, and physical function has been recommended in diagnosing sarcopenia. However, only muscle mass has been assessed in previous studies. Therefore, this study investigated the effect of comprehensively diagnosed preoperative sarcopenia on the prognosis of patients with esophageal cancer.

Methods

The study analyzed 115 patients with esophageal cancer (age ≥ 65 years) who underwent curative esophagectomy. Preoperative sarcopenia was analyzed using the skeletal mass index (SMI), handgrip strength, and gait speed based on the Asian Working Group for Sarcopenia 2019 criteria. Clinicopathologic factors, incidence of postoperative complications, and overall survival (OS) were compared between the sarcopenia and non-sarcopenia groups. The significance of the three individual parameters also was evaluated.

Results

The evaluation identified 47 (40.9%) patients with low SMI, 31 (27.0%) patients with low handgrip strength, and 6 (5.2%) patients with slow gait speed. Sarcopenia was diagnosed in 23 patients (20%) and associated with older age and advanced pT stage. The incidence of postoperative complications did not differ significantly between the two groups. Among the three parameters, only slow gait speed was associated with Clavien-Dindo grade 2 or greater complications. The sarcopenia group showed significantly worse OS than the non-sarcopenia group. Those with low handgrip strength tended to have worse OS, and those with slow gait speed had significantly worse OS than their counterparts.

Conclusions

Preoperative sarcopenia diagnosed using skeletal muscle mass, muscle strength, and physical function may have an impact on the survival of patients with esophageal cancer.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan

    Takashi Kanemura MD, PhD, Tomohira Takeoka MD, PhD, Takahito Sugase MD, PhD, Shinya Urakawa MD, PhD, Yasunori Masuike MD, PhD, Naoki Shinno MD, PhD, Hisashi Hara MD, PhD, Masatoshi Kitakaze MD, PhD, Masahiko Kubo MD, PhD, Yousuke Mukai MD, PhD, Toshinori Sueda MD, PhD, Shinichiro Hasegawa MD, PhD, Hirofumi Akita MD, PhD, Junichi Nishimura MD, PhD, Hiroshi Wada MD, PhD, Masayoshi Yasui MD, PhD, Takeshi Omori MD, PhD & Hiroshi Miyata MD, PhD

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Correspondence to Hiroshi Miyata MD, PhD.

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Fig. S1

Comparison of disease-specific survival (DSS) between the sarcopenia and non-sarcopenia groups (TIF 3069 KB)

Supplementary file2 (DOCX 18 KB)

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Kanemura, T., Takeoka, T., Sugase, T. et al. Significance of Comprehensive Analysis of Preoperative Sarcopenia Based on Muscle Mass, Muscle Strength, and Physical Function for the Prognosis of Patients with Esophageal Cancer. Ann Surg Oncol 31, 818–826 (2024). https://doi.org/10.1245/s10434-023-14306-5

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