Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajiicho Hirokoji Kawaramachi Kamigyo-ku, Kyoto, 602-8566, Japan.
Med Oncol. 2019 Jan 2;36(2):15. doi: 10.1007/s12032-018-1242-0.
Undernutrition and sarcopenia are associated with a higher incidence of chemotherapy-related toxicity and a poor prognosis in several kinds of cancer, but the impact of sarcopenia on the outcomes of chemotherapy for esophageal cancer remains unclear. Thus, the purpose of this retrospective study was to investigate whether sarcopenia affects the efficacy and toxicities of chemotherapy for advanced esophageal cancer patients. Data were collected from 31 esophageal cancer patients who underwent neo-adjuvant chemotherapy followed by surgery. Body composition was assessed at the start of chemotherapy by bioelectrical impedance analysis, and outcomes of chemotherapy were compared between sarcopenic and non-sarcopenic groups. Of the 31 patients, sarcopenia was observed in 16 (51.6%). The incidence of toxicities was not different between the two groups. However, as for pathologic response, a good therapeutic effect (Grade 2 or higher) was more common in the non-sarcopenic group than in the sarcopenic group (53.3% vs. 25.0%). Multivariate analysis showed that sarcopenia was an independent predictor of poor pathological response (odds ratio 8.02; P = 0.037). The results of this study suggest the potential utility of sarcopenia assessment in neoadjuvant patient selection strategies.
营养不良和肌肉减少症与多种癌症的化疗相关毒性发生率升高和预后不良相关，但肌肉减少症对食管癌化疗结局的影响尚不清楚。因此，本回顾性研究旨在探讨肌肉减少症是否影响晚期食管癌患者化疗的疗效和毒性。从接受新辅助化疗后手术的 31 名食管癌患者中收集数据。在化疗开始时通过生物电阻抗分析评估身体成分，并比较肌肉减少症组和非肌肉减少症组的化疗结局。在 31 名患者中，观察到 16 名（51.6%）存在肌肉减少症。两组的毒性发生率无差异。然而，就病理反应而言，非肌肉减少症组的治疗效果较好（2 级或更高）的比例高于肌肉减少症组（53.3%比 25.0%）。多变量分析显示，肌肉减少症是病理反应不良的独立预测因素（优势比 8.02；P = 0.037）。本研究结果表明，肌肉减少症评估在新辅助患者选择策略中有潜在的应用价值。
