TY - JOUR
T1 - Prognostic significance of low muscle volume in patients undergoing surgery for oesophageal cancer
AU - Powell, Arfon
AU - Mulla, Mubashir
AU - Eley, Catherine
AU - Patel, Neil
AU - Abdelrahman, Tarig
AU - Blake, Paul
AU - Barlow, Rachael
AU - Bailey, Damian
AU - Lewis, Wyn
N1 - Funding Information:
DMB is supported by a Royal Society Wolfson Research Fellowship ( #WM170007 ), Royal Society International Exchanges Award ( IES∖R2∖192137 ), and Japan Society for the Promotion of Science Research Fellowship ( #JSPS/OF317 ).
Publisher Copyright:
© 2020 European Society for Clinical Nutrition and Metabolism
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background & aims: This study aimed to determine the prognostic significance of low muscle volume (LMV) Bioelectrical Impedance Analysis (BIA), defined skeletal muscle index (SMI, Kg/m2 male ≤8.75, female ≤5.75) in patients undergoing potentially curative surgery for Oesophageal Cancer (OC). Methods: A prospective study of 122 patients diagnosed with OC [median age 65 yr, 104 male, 65 neoadjuvant therapy] who underwent preoperative BIA (Maltron Bioscan 920). Primary outcome measure was Overall Survival (OS). Results: LMV was identified in 11 (9.0%) of patients, which was associated with low lean muscle mass (27.3 vs. 31.1 kg, p = 0.012), low body fat (8.8 vs.19.3 kg, p < 0.001), and greater total body water (72.2 vs. 62.2%, p = 0.001), and more open & close laparotomies (36.4 vs. 8.1%, p = 0.012). Median and 5-year OS was 16 months and 18.2% in LMV patients, compared with 51 months and 52.4% in non-sarcopenic patients (p = 0.002). On multivariable analysis of pre-operative variables, only LMV (HR 2.75; 95% CI 1.33–5.66, p = 0.006) was associated with OS. Conclusion: BIA is an important prognostic indicator in OC and focused pre-habilitation consequently has strong potential.
AB - Background & aims: This study aimed to determine the prognostic significance of low muscle volume (LMV) Bioelectrical Impedance Analysis (BIA), defined skeletal muscle index (SMI, Kg/m2 male ≤8.75, female ≤5.75) in patients undergoing potentially curative surgery for Oesophageal Cancer (OC). Methods: A prospective study of 122 patients diagnosed with OC [median age 65 yr, 104 male, 65 neoadjuvant therapy] who underwent preoperative BIA (Maltron Bioscan 920). Primary outcome measure was Overall Survival (OS). Results: LMV was identified in 11 (9.0%) of patients, which was associated with low lean muscle mass (27.3 vs. 31.1 kg, p = 0.012), low body fat (8.8 vs.19.3 kg, p < 0.001), and greater total body water (72.2 vs. 62.2%, p = 0.001), and more open & close laparotomies (36.4 vs. 8.1%, p = 0.012). Median and 5-year OS was 16 months and 18.2% in LMV patients, compared with 51 months and 52.4% in non-sarcopenic patients (p = 0.002). On multivariable analysis of pre-operative variables, only LMV (HR 2.75; 95% CI 1.33–5.66, p = 0.006) was associated with OS. Conclusion: BIA is an important prognostic indicator in OC and focused pre-habilitation consequently has strong potential.
KW - Low muscle volume
KW - Morbidity
KW - Oesophageal cancer
KW - Survival
U2 - 10.1016/j.clnesp.2020.09.016
DO - 10.1016/j.clnesp.2020.09.016
M3 - Article
C2 - 33183540
AN - SCOPUS:85091684505
SN - 2405-4577
VL - 40
SP - 220
EP - 225
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
ER -