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Relationship Between Sarcopenia and Prognosis in Patient With Concurrent Chemo-Radiation Therapy for Esophageal Cancer

 Dae Won Ma  ;  Yeona Cho  ;  Mi-jin Jeon  ;  Jie-Hyun Kim  ;  Ik Jae Lee  ;  Young Hoon Youn  ;  Jae Jun Park  ;  Da Hyun Jung  ;  Hyojin Park  ;  Chang Geol Lee  ;  Jun Won Kim  ;  Hei Cheul Jeung 
 FRONTIERS IN ONCOLOGY, Vol.9 : 366, 2019 
Journal Title
Issue Date
complication ;  concurrent chemo- and radiotherapy ;  esophageal cancer ;  prognosis ;  sarcopenia
Background: Sarcopenia, defined as skeletal muscle loss, has been known as a poor prognosis factor in various malignant diseases The aim of this study is to investigate the effect of sarcopenia on prognosis in patients with esophageal cancer who received concurrent chemo- and radiotherapy (CCRT). Methods: We retrospectively collected clinical data of 287 patients with esophageal cancer who were treated by definite CCRT at Gangnam Severance and Severance hospital from August 2005 to December 2014. The cross-sectional area of muscle at the level of the third lumbar vertebra was measured using pre- and post-CCRT computed tomography images. Sarcopenia was defined as skeletal muscle index <49 cm2/m2 for men and of <31 cm2/m2 for women by Korean-specific cutoffs. Overall survival (OS) and progression free survival (PFS) were analyzed according to sarcopenia. Results: Sarcopenia identified before CCRT did not affect OS and PFS. However, patients with post-CCRT sarcopenia showed shorter OS and PFS than patients without it (median OS: 73 months vs. 28 months; median PFS: 34 months vs. 25 months, respectively). Post-CCRT sarcopenia was an independent prognostic factor of poor OS (hazards ratio: 1.697; 95% confidence interval: 1.036-2.780; P = 0.036). In multivariate analysis, male sex (P = 0.004) and presence of CCRT-related complications, such as esophagitis or general weakness were significantly associated with post-CCRT sarcopenia (P = 0.016). Conclusions: Sarcopenia after CCRT can be a useful predictor for long-term prognosis in patients with esophageal cancer. To control CCRT-related complications may be important to prevent skeletal muscle loss during CCRT.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
7. Others (기타) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Jeon, Mi Jin(전미진)
Jung, Da Hyun(정다현)
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
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