Impact of Sarcopenia in the Prognostic of Ressectable Esophageal Cancer

Abstract

Background: Sarcopenia is an important prognostic factor in oncologic patients. In Esophageal Cancer, sarcopenia is associated with increased postoperative morbidity; however, there is no a clear association with mortality. Purpose: To assess the impact of sarcopenia on morbidity and mortality, and evaluate the survival rates of patients who underwent curative esophagectomy for Esophageal Cancer. Methods: Retrospective analysis of 71 patients with esophageal squamous cell carcinoma and esophageal adenocarcinoma, treated between 1st January 2004 and 30th September 2017. In order to obtain the skeletal muscle index, L3 muscle area was assessed through Computed Tomography. T test for independent samples, Mann-Whitney test, Qui-squared test and Fisher’s test were used when pertinent, to compare the data from sarcopenic and non-sarcopenic groups. Disease-free survival and overall survival rates were calculated using Kaplan-Meier method and Cox regression modeling. Results: Sarcopenia prevalence was 23.9% (17 patients). Patients with sarcopenia presented a mean muscle area of 138 cm2 (± 11.7), significantly lower than the nonsarcopenic group (t (64.02)=5.84, p<.001, d=1.29), and a median skeletal muscle index of 49.3 cm2/m2 (3.46), significantly lower than the non-sarcopenic patients (U=58.0, p<.001, r=-.64). Sarcopenia was associated with a lower disease-free survival; however, it has not been a significant predictor when confounders were controlled. Conclusions: In this study, sarcopenia was not associated with a higher postoperative morbimortality neither with a lower disease-free and overall survival.