Effect of Body Composition Change during Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

Onishi, Sachiyo; Tajika, Masahiro; Tanaka, Tsutomu; Yamada, Keisaku; Kamiya, Tomoyasu; T, Abe; Higaki, Eiji; Fujieda, Hironori; Nagao, Takuya; Inaba, Yoshitaka; Muro, Kei; Shimizu, Masahito; Niwa, Yasumasa

doi:10.3390/jcm11030508

Cited by 6 publications

(6 citation statements)

References 53 publications

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“…Whether special nutritional interventions in addition to conventional methods are necessary during the course of DCF treatment with such side effects has not been extensively reported to date. We previously reported the effects of changes in body composition in patients receiving neoadjuvant chemotherapy [9,14] . Previous studies reported that changes in body composition, especially skeletal muscle mass, had an impact on the incidence of perioperative complications and prognosis within 2-3 months after NAC treatment.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously reported the prognostic impact of changes in body composition during NAC. Moreover, post-NAC sarcopenia is a more important prognostic factor compared with pre-NAC sarcopenia [9] and may be secondary to treatment-related gastrointestinal toxicity in addition to cachexia, which is associated with malignancy. We aimed to examine the changes in body composition before and after NAC to determine whether nutritional management is necessary for patients treated with DCF, which is likely to be used more frequently in the future compared with conventional treatment.…”

Section: Introductionmentioning

confidence: 99%

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Prevention of the Adverse Effects of Neoadjuvant Chemotherapy for Esophageal Cancer: Role of Nutritional Management in Different Neoadjuvant Chemotherapy Regimens

Onishi

Tajika

Tanaka

et al. 2023

Preprint

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Based on the results of the JCOG1109 trial, docetaxel + cisplatin + 5-fluorouracil (DCF) may be a standard neoadjuvant chemotherapy (NAC), in addition to the conventional 5-fluorouracil and cisplatin (FP) therapy. We examined whether the nutritional therapy should be modified when a different NAC is used based on the changes in body composition. The study included 215 patients with advanced esophageal cancer who underwent surgery after receiving NAC at our hospital between 2013 and 2019, and those who underwent abdominal computed tomography before and after NAC. The skeletal muscle mass index (SMI) was calculated using the following formula: total skeletal muscle mass at the third lumbar level/height2. The visceral and subcutaneous fat masses were assessed at the umbilical level. The lower 25% of men and women were defined as the low visceral fat and low subcutaneous fat groups, respectively. The DCF group was significantly younger (p < 0.01), had higher proportion of men (p = 0.03), and had higher proportion of patients with cStage III disease (p < 0.01) compared with the FP group. The body composition changes were not significantly different in terms of percentage changes in SMI and visceral fat mass. Multivariate analysis showed that cStage III disease and a shift to low visceral fat were prognostic factors, whereas differences in NAC were not. Although no significant difference was found in the body composition before and after NAC, aggressive nutritional management is recommended during NAC, especially because a shift to a low visceral fat affects the patient’s prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevention of the Adverse Effects of Neoadjuvant Chemotherapy for Esophageal Cancer: Role of Nutritional Management in Different Neoadjuvant Chemotherapy Regimens

Onishi

Tajika

Tanaka

et al. 2023

Preprint

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“…A multicenter study demonstrated that neoadjuvant chemoradiation in esophageal cancer patients increased the percentage of sarcopenia [ 64 ], and another study found that 32.5% of esophageal cancer patients had body composition changes during NAC (patients with ≥ 3% increase in visceral fat mass (VFM) and ≥ 3% decrease in PMI) [ 87 ]. In addition, a systematic review noted that esophageal cancer patients receiving chemotherapy are at risk for severe loss of skeletal muscle mass [ 88 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition to employing SMI values to define sarcopenia and determine esophageal cancer prognosis in most studies, numerous researchers have utilized alternative methods as prognostic indicators for esophageal cancer. For instance, several studies have showcased the predictive role of skeletal muscle mass loss in determining esophageal cancer prognosis [ 51 , 87 , 88 , 94 ]. Moreover, measurements of the total psoas major area (TPA) [ 59 ] and the psoas muscle index [ 53 ] have been utilized as surrogate markers of sarcopenia to predict postoperative complications, overall survival (OS), and recurrence-free survival (RFS) in esophageal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Correlation between sarcopenia and esophageal cancer: a narrative review

Li,

Xie,

Xiao

et al. 2024

World J Surg Onc

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Background In recent years, the research on the relationship between sarcopenia before and after the treatment of esophageal cancer, as well as its impact on prognosis of esophageal cancer, has increased rapidly, which has aroused people’s attention to the disease of patients with esophageal cancer complicated with sarcopenia. This review examines the prevalence of sarcopenia in patients with esophageal cancer, as well as the relationship between sarcopenia (before and after surgery or chemotherapy) and prognosis in patients with esophageal cancer. Moreover, we summarized the potential pathogenesis of sarcopenia and pharmacologic and non-pharmacologic therapies. Methods A narrative review was performed in PubMed and Web of Science using the keywords (“esophageal cancer” or “esophageal neoplasm” or “neoplasm, esophageal” or “esophagus neoplasm” or “esophagus neoplasms” or “neoplasm, esophagus” or “neoplasms, esophagus” or “neoplasms, esophageal” or “cancer of esophagus” or “cancer of the esophagus” or “esophagus cancer” or “cancer, esophagus” or “cancers, esophagus” or “esophagus cancers” or “esophageal cancer” or “cancer, esophageal” or “cancers, esophageal” or “esophageal cancers”) and (“sarcopenia” or “muscular atrophy” or “aging” or “senescence” or “biological aging” or “aging, biological” or “atrophies, muscular” or “atrophy, muscular” or “muscular atrophies” or “atrophy, muscle” or “atrophies, muscle” or “muscle atrophies”). Studies reporting relationship between sarcopenia and esophageal cancer were analyzed. Results The results of the review suggest that the average prevalence of sarcopenia in esophageal cancer was 46.3% ± 19.6% ranging from 14.4 to 81% and sarcopenia can be an important predictor of poor prognosis in patients with esophageal cancer. Patients with esophageal cancer can suffer from sarcopenia due to their nutritional deficiencies, reduced physical activity, chemotherapy, and the effects of certain inflammatory factors and pathways. When classic diagnostic values for sarcopenia such as skeletal muscle index (SMI) are not available clinically, it is also feasible to predict esophageal cancer prognosis using simpler metrics, such as calf circumference (CC), five-count sit-up test (5-CST), and six-minute walk distance (6MWD). Conclusions Identifying the potential mechanism of sarcopenia in patients with esophageal cancer and implementing appropriate interventions may hold the key to improving the prognosis of these patients.

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“…Preoperative sarcopenia has also been identified as a factor that decreases short-and long-term postoperative prognosis after various gastrointestinal cancer surgeries [10][11][12][13]. In patients with stage II or III ESCC, preoperative sarcopenia has been reported to be associated with increased perioperative complications [14][15][16] and poor prognosis [17][18][19]. Recently, not only muscle mass but also muscle quality has been assessed, and the intramuscular adipose tissue content (IMAC) [20] has been used as a measure of muscle quality [21,22].…”

Section: Introductionmentioning

confidence: 99%

Skeletal Muscle Quality and Quantity Affect Prognosis after Neoadjuvant Chemotherapy with a Triple Regimen of Docetaxel/Cisplatin/5-FU in Patients with Esophageal Cancer

Ito,

Tajika,

Tanaka

et al. 2023

JCM

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The purpose of this study was to identify factors associated with the prognosis after docetaxel, cisplatin, and 5-fluorouracil (DCF) neoadjuvant chemotherapy (NAC) in patients with advanced esophageal squamous cell carcinoma (ESCC) undergoing surgical resection. We retrospectively examined a total of 100 patients who received neoadjuvant DCF therapy for ESCC at our institution between 2011 and 2020. The psoas muscle index (PMI) was calculated from the psoas muscle area at the L3 vertebral level, and the intramuscular adipose tissue content (IMAC) was calculated from the mean CT value of the multifidus muscle and from four points of subcutaneous fat. The median PMI value was 6.11 cm2/m2 (range, 3.12–11.07 cm2/m2) in men and 3.65 cm2/m2 (range, 2.70–6.82 cm2/m2) in women. The median IMAC was −0.426 (range, −0.079–−0.968) in men and −0.359 (range, −0.079–−0.671) in women. Based on the PMI, IMAC, and other patient factors, factors associated with NAC-DCF postoperative survival were identified using multivariate Cox regression analysis. A high IMAC was significantly related to overall survival after surgery (p = 0.005, hazard ratio 2.699). A comparison of Kaplan–Meier curves showed that the 5-year survival rate was 76.5% in the low IMAC group and 42.7% in the high IMAC group (log-rank test; p = 0.001). A low IMAC was associated with good survival outcomes and was an independent prognostic factor in patients with cStage II/III ESCC who were treated with the NAC-DCF regimen and underwent surgical resection.

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Effect of Body Composition Change during Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

Cited by 6 publications

References 53 publications

Prevention of the Adverse Effects of Neoadjuvant Chemotherapy for Esophageal Cancer: Role of Nutritional Management in Different Neoadjuvant Chemotherapy Regimens

Prevention of the Adverse Effects of Neoadjuvant Chemotherapy for Esophageal Cancer: Role of Nutritional Management in Different Neoadjuvant Chemotherapy Regimens

Correlation between sarcopenia and esophageal cancer: a narrative review

Skeletal Muscle Quality and Quantity Affect Prognosis after Neoadjuvant Chemotherapy with a Triple Regimen of Docetaxel/Cisplatin/5-FU in Patients with Esophageal Cancer

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