Prognostic value of sarcopenia and myosteatosis alterations on survival outcomes for esophageal squamous cell carcinoma before and after radiotherapy

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2024-07-18 DOI:10.1016/j.nut.2024.112536

Ningjing Yang M.S. , Peng Zhou M.S. , Jiahua Lyu M.D. , Jing Ren M.S. , Xinyu Nie M.S. , Sijia Zhao M.S. , Yihong Ye M.S.

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引用次数: 0

Abstract

Objective

We assessed the impact and prognostic significance of alterations in muscle quality and quantity (myosteatosis and sarcopenia, respectively) in patients with esophageal cancer treated with radiotherapy (RT).

Methods

We retrospectively pooled 258 patients with esophageal squamous cell cancer who underwent RT. Myosteatosis and sarcopenia were determined based on the skeletal muscle index derived from the muscle area and attenuation at the L3 level from computed tomography images. Subgroups were formed as 2 subgroups of non-sarcopenia/myosteatosis and sarcopenia/myosteatosis (with or without other muscle status) at either timepoint of RT, 3 subgroups of only-sarcopenia, only myosteatosis (without other muscle status), and the co-presence of sarcopenia and myosteatosis at either timepoint of RT, as well as 4 subgroups of continuous sarcopenia/myosteatosis, developed sarcopenia/myosteatosis, reduced sarcopenia/myosteatosis and non-sarcopenia/myosteatosis according to alterations of muscle status at both timepoints of RT. Overall survival (OS) was compared. Univariate and multivariate analyses based on Cox regression identified independent risk factors for prognosis.

Results

Either pre- or post-RT, patients with sarcopenia and myosteatosis (with or without other muscle status) had poor OS. Patients with only myosteatosis (without other muscle status) showed the best OS (1352 days pre-RT vs. 1648 days post-RT), while patients with concurrent myosteatosis and sarcopenia had the worst OS (907 days pre-RT vs. 706 days post-RT). The ascending order of OS for sarcopenia alterations was as follows: continuous sarcopenia (1093 days), non-sarcopenia (1740 days), developed sarcopenia (2187 days), and reduced sarcopenia (2208 days) (P = 0.002). The ascending order of OS for myosteatosis alterations was ranked as follows: continuous myosteatosis (1165 days), reduced myosteatosis (1275 days), developed myosteatosis (1783 days), and non-myosteatosis (1942 days) (P = 0.061). Univariate and multivariate Cox regression analyses revealed that increased age, longer tumor length, developed myosteatosis, and continuous myosteatosis were independent prognostic factors for OS.

Conclusions

Muscle mass status at presentation and alterations in patients with esophageal cancer before and after RT should be considered prognostic indicators.

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放疗前后肌少症和肌骨变性对食管鳞状细胞癌生存结果的预后价值

目的我们评估了肌肉质量和数量的改变（分别为肌骨肥大症和肌肉疏松症）对接受放射治疗（RT）的食管癌患者的影响和预后意义。根据计算机断层扫描图像的肌肉面积和 L3 水平的衰减得出的骨骼肌指数，确定了肌骨软化症和肌肉疏松症。在任何一个 RT 时间点，均分为非肌肉疏松症/肌肉肥大症和肌肉疏松症/肌肉肥大症（伴有或不伴有其他肌肉状态）2 个亚组，以及仅有肌肉疏松症、仅有肌骨肥大症（不伴有其他肌肉状态）3 个亚组、以及在RT的任一时间点同时存在肌少症和肌骨质疏松症，并根据RT的任一时间点肌肉状态的变化分为持续性肌少症/肌骨质疏松症、发展性肌少症/肌骨质疏松症、减轻性肌少症/肌骨质疏松症和非肌少症/肌骨质疏松症4个亚组。对总生存期（OS）进行了比较。基于 Cox 回归的单变量和多变量分析确定了预后的独立风险因素。结果无论是在 RT 前还是 RT 后，肌肉疏松症和肌骨质疏松症（伴有或不伴有其他肌肉状态）患者的 OS 都很差。仅患有肌骨质疏松症（无其他肌肉状态）的患者OS最佳（RT前1352天 vs. RT后1648天），而同时患有肌骨质疏松症和肌肉疏松症的患者OS最差（RT前907天 vs. RT后706天）。肌少症改变的OS由高到低依次为：持续性肌少症（1093天）、非肌少症（1740天）、发展性肌少症（2187天）和减轻性肌少症（2208天）（P = 0.002）。肌骨疏松改变的OS升序排列如下：持续性肌骨疏松（1165天）、减轻性肌骨疏松（1275天）、发达性肌骨疏松（1783天）和非肌骨疏松（1942天）（P = 0.061）。单变量和多变量 Cox 回归分析显示，年龄增加、肿瘤长度延长、发达型肌骨营养不良和持续性肌骨营养不良是 OS 的独立预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.