112P Prognostic role of sarcopenia before neoadjuvant chemoradiotherapy in patients with esophageal cancer: A retrospective study

M. Sanei, M. Garousi, M. Kaheh

Annals of Oncology(2022)

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Abstract
Sarcopenia is known as a prognostic factor before surgery in esophageal carcinoma, however there is limited data about its exact value before neoadjuvant chemoradiotherapy. Therefore, the aim of present study was to evaluate sarcopenia prevalence before neoadjuvant chemoradiotherapy in patients with esophageal cancer and its relation with pathologic response to treatment. In this retrospective study, all patients with esophageal cancer referred to Firoozgar hospital, Tehran during 2019 to 2021 who underwent neoadjuvant chemoradiotherapy followed by esophagectomy were included. Muscle mass was measured using a pre-treatment third lumbar vertebra CT-scan slice. Sarcopenia was internationally defined as skeletal muscle index of less than 39 cm2/m2 in women and less than 55 cm2/m2 in men. Association of sarcopenia with demographic and pathologic parameters and patients survival was statistically analyzed. Totally 67 patients including 34 men (50.7%) entered the study. Squamous cell carcinoma was the most common pathology in 91% of patients. Skeletal muscle index measurement was available in 58 patients in whom 56 (96.6%) showed sarcopenia. The mean of skeletal muscle index in men and women were 19.70 ± 8.01 and 19.63 ± 8.87 cm2/m2 respectively with no statistically significant difference. There was no significant correlation between sarcopenia with age, tumor pathology, tumor site or staging. The mean of skeletal muscle index in T2 tumors was significantly more than other stages (P=0.032). There was no significant relationship between sarcopenia and patients clinical outcome and survival. However skeletal muscle index was significantly higher in patients with complete pathologic response (P=0.004). Frequency of pre-treatment sarcopenia was very high in patients with esophageal cancer. There was no association between sarcopenia before neoadjuvant chemoradiotherapy and the clinical outcome in patients with esophageal carcinoma but it affected complete pathologic response to therapy.
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