低骨骼肌质量有助于浅表性食管癌患者接受明确的放化疗的预后。

IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Esophagus Pub Date : 2025-04-01 Epub Date: 2025-01-30 DOI:10.1007/s10388-025-01109-8
Kentaro Nakagawa, Yoshito Hayashi, Yujiro Adachi, Ayaka Tajiri, Hiromu Fukuda, Eiji Kimura, Ryotaro Uema, Hirotsugu Saiki, Minoru Kato, Takanori Inoue, Takeo Yoshihara, Shunsuke Yoshii, Yoshiki Tsujii, Tetsuo Takehara
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引用次数: 0

摘要

背景:本研究旨在探讨浅表性食管癌患者接受明确放化疗(CRT)后肌肉减少症、中性粒细胞-淋巴细胞比率(NLR)、Charlson合并症指数(CCI)和预后营养指数(PNI)之间的关系。方法:回顾性分析100例诊断为cT1N0M0型食管鳞状细胞癌的患者(男性87例)。纳入的患者接受CRT作为初始治疗。使用腰肌指数(PMI)评估肌肉质量。所有患者同时接受化疗(5-氟尿嘧啶+顺铂/奈达铂)和放疗(60 Gy)。随访时间(中位范围)为78(2.5-197)个月。在随访期间,23例复发,37例死亡(11例死于食道癌;只有一例与治疗有关的死亡)。结果:5年生存率为78.0%。男性和女性的PMI中位数(范围)分别为6.55(3.90-10.9)和4.62 (2.28-6.60)cm2/m2。PNI为46.6 (36.2 ~ 60.4),NLR为2.45 (0.61 ~ 18.1),CCI为0(0 ~ 10)。患者分为低PMI(肌肉减少)组和高PMI(非肌肉减少)组。在单因素生存时间分析中,低PMI组的风险比(HR)为2.70 (p = 0.0049),低Geriatric营养风险指数(GNRI)组的风险比(HR)为2.30 (p = 0.0161), CCI≥1组的风险比(HR)为2.19 (p = 0.0199)。根据这三个因素与年龄(≥65岁)的多因素分析,PMI是独立的预后因素(HR, 2.23;p = 0.0313)。结论:PMI是T1N0M0食管癌行CRT患者预后的显著预测因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Low skeletal muscle mass contributes to the prognosis of patients with superficial esophageal cancer treated with definitive chemoradiotherapy.

Background: Herein, we aimed to examine the relationship between sarcopenia, neutrophil-lymphocyte ratio (NLR), Charlson comorbidity index (CCI), and prognostic nutritional index (PNI) in patients with superficial esophageal carcinoma who underwent definitive chemoradiotherapy (CRT).

Methods: We retrospectively analyzed 100 patients (87 males) diagnosed with cT1N0M0 esophageal squamous cell carcinoma. The included patients underwent CRT as an initial treatment. Muscle mass was assessed using the psoas muscle index (PMI). All patients received concurrent chemotherapy (5-fluorouracil plus cisplatin/nedaplatin) and radiotherapy (60 Gy). The duration of follow-up (median range) was 78 (2.5-197) months. During the follow-up period, 23 recurrences occurred, along with 37 deaths (11 deaths from esophageal cancer; only one treatment-related death).

Results: The 5-year survival rate was 78.0%. The median (range) PMI was 6.55 (3.90-10.9) and 4.62 (2.28-6.60) cm2/m2 in males and females, respectively. The PNI was 46.6 (36.2-60.4), NLR was 2.45 (0.61-18.1), and CCI was 0 (0-10). Patients were divided into low PMI (sarcopenia) and high PMI (non-sarcopenia) groups. In the univariate survival time analysis, the low PMI group had a significant hazard ratio (HR) of 2.70 (p = 0.0049), the low Geriatric Nutritional Risk Index (GNRI) group had an HR of 2.30 (p = 0.0161), and the CCI ≥ 1 group had an HR of 2.19 (p = 0.0199). According to the multivariate analysis using these three factors and age (≥ 65 years), PMI was an independent prognostic factor (HR, 2.23; p = 0.0313).

Conclusions: PMI is a notable predictor of prognosis in patients undergoing CRT for T1N0M0 esophageal cancer.

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来源期刊
Esophagus
Esophagus GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.90
自引率
8.30%
发文量
78
审稿时长
>12 weeks
期刊介绍: Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.
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