Sarcopenia Resulting from Neoadjuvant Therapy May Decrease Esophageal Cancer Survival

Sarcopenia identified as an independent risk factor.

Sarcopenia is linked to poorer survival outcomes after esophageal resection in patients who undergo neoadjuvant therapy, according to a study published in the European Journal of Cancer Surgery.

For the study, the authors sought to evaluate the impact sarcopenia and body composition changes during multimodal therapy have on long-term outcomes after esophageal resection in patients who have undergone neoadjuvant therapy.

The investigators measured skeletal muscle index and body composition parameters in patients who received neoadjuvant treatment for locally advanced esophageal cancer. Relapse-free survival and overall survival (OS) were the endpoints of the study.

Included in the study were 130 patients, of whom 80 had sarcopenia. The findings showed that patients with squamous cell carcinoma experienced a decreased median skeletal muscle index of 48 cm/m2 compared with that of patients with adenocarcinoma of 52 cm/m2,.

Patients who experienced sarcopenia at any point during study treatment had a poor prognosis for survival compared with patients who did not. The median OS was 20.5 months versus 52.1 months, respectively. The investigators identified sarcopenia as an independent risk factor.

“Sarcopenia is not necessarily a side effect [sic] of chemotherapy,” said lead author Matthias Paireder. “Many patients were already sarcopenic before the treatment and there was no significant progression of sarcopenia during treatment. The reasons for this loss of general muscle mass are poor nutrition and lack of exercise.”

In additional studies, the investigators plan to determine whether a program that includes nutritional advice and physical training could significantly increase long-term survival among patients with esophageal cancer.