Journal
EUROPEAN RADIOLOGY
Volume 24, Issue 5, Pages 998-1005Publisher
SPRINGER
DOI: 10.1007/s00330-014-3110-4
Keywords
Sarcopenia; Body composition; Neoadjuvant chemotherapy; Oesophageal cancer
Funding
- Department of Health via the National Institute of Health Research Biomedical Research Centre
- St Thomas' NHS Foundation Trust
- King's College London
- King's College Hospital NHS Foundation Trust
- Comprehensive Cancer Imaging Centre
- Cancer Research UK
- Engineering and Physical Sciences Research Council
- Medical Research Council
- Department of Health
- Cancer Research UK [16463] Funding Source: researchfish
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Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 % +/- 6.4 (SD) in comparison to FM index (-1.2 +/- 4.2), FFM index (-4.6 +/- 6.8), FMR (-1.2 +/- 24.3) and VA/SA (-62.3 +/- 12.7). Changes in FM index (p = 0.022), FMR (p = 0.028), VA/SA (p = 0.024) and weight (p = 0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. aEuro cent Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer. aEuro cent Sarcopenia was more prevalent after neoadjuvant chemotherapy. aEuro cent Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy. aEuro cent Changes in body composition were associated with CRM positivity. aEuro cent Changes in body composition did not affect perioperative complications and survival.
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