Saeki Hiroshi, Nakashima Yuichiro, Kudou Kensuke, Sasaki Shun, Jogo Tomoko, Hirose Kosuke, Edahiro Keitaro, Korehisa Shotaro, Taniguchi Daisuke, Nakanishi Ryota, Kubo Nobuhide, Ando Koji, Kabashima Akira, Oki Eiji, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
World J Surg. 2018 Sep;42(9):2894-2901. doi: 10.1007/s00268-018-4554-5.
Since the clinical impact of sarcopenia on multimodal therapy for patients with esophageal cancer is not well understood, this study was conducted to determine the influence of sarcopenia on the efficacy of neoadjuvant chemoradiotherapy (NACRT) for locally advanced esophageal cancer.
The skeletal muscle index was quantified at the level of the third lumbar vertebra on computed tomography images, and sarcopenia was defined as a skeletal muscle index that was less than the average for each gender. We compared treatment outcomes in patients with cT3 and nearly T4 thoracic esophageal squamous cell carcinoma between the sarcopenia group (n = 85) and the non-sarcopenia group (n = 72).
The 5-year survival rates were 33.4% in the non-sarcopenia group and 31.5% in the sarcopenia group; these differences were not significant. The prognosis of the patients with sarcopenia was worse than that of the patients without sarcopenia in the surgery-alone group, but there was no difference between patients with and without sarcopenia in the NACRT group.
NACRT could be a useful option for patients with locally advanced esophageal squamous cell carcinoma, even for those with sarcopenia, without increasing the incidence of morbidity and mortality.
由于肌肉减少症对食管癌患者多模式治疗的临床影响尚未完全明确，本研究旨在确定肌肉减少症对局部晚期食管癌新辅助放化疗（NACRT）疗效的影响。
在计算机断层扫描图像上，于第三腰椎水平对骨骼肌指数进行量化，肌肉减少症定义为骨骼肌指数低于各性别平均值。我们比较了肌肉减少症组（n = 85）和非肌肉减少症组（n = 72）中cT3和接近T4期胸段食管鳞状细胞癌患者的治疗结果。
非肌肉减少症组的5年生存率为33.4%，肌肉减少症组为31.5%；这些差异无统计学意义。在单纯手术组中，肌肉减少症患者的预后比无肌肉减少症患者差，但在新辅助放化疗组中，有或无肌肉减少症的患者之间无差异。
新辅助放化疗可能是局部晚期食管鳞状细胞癌患者的一种有效选择，即使是肌肉减少症患者，也不会增加发病率和死亡率。
