The Influence of Pretherapeutic and Preoperative Sarcopenia on Short-Term Outcome after Esophagectomy
1
Department of Surgery, Universitäts Medizin Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
2
Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(11), 3409; https://doi.org/10.3390/cancers12113409
Received: 20 October 2020
/
Revised: 8 November 2020
/
Accepted: 14 November 2020
/
Published: 17 November 2020
(This article belongs to the Special Issue Multimodal Therapy of Upper Gastrointestinal Malignancies)
Simple Summary
Although introducing minimally invasive surgery reduced postoperative morbidity after esophagectomy esophageal cancer still is a malignancy with poor prognosis. This study aimed to investigate whether preoperative sarcopenia has an influence on short-term postoperative outcome after esophagectomy in esophageal cancer patients. Our findings suggest that preoperative sarcopenia is no independent prognostic factor for postoperative outcome after esophagectomy but that patients’ nutritional status consists of more factors than only body mass index (BMI) and muscle mass. Prehabilitation and preoperative optimization of the patients’ nutritional status seems to be an important factor for short-term postoperative outcome after esophagectomy.
By introducing minimally invasive surgery the rate of postoperative morbidity in esophageal cancer patients could be reduced. But esophagectomy is still associated with a relevant risk of postoperative morbidity and mortality. Patients often present with nutritional deficiency and sarcopenia even at time of diagnosis. This study focuses on the influence of skeletal muscle index (SMI) on postoperative morbidity and mortality. Fifty-two patients were included in this study. SMI was measured using computer tomographic images at the time of diagnosis and before surgery. Then, SMI and different clinicopathological and demographic features were correlated with postoperative morbidity. There was no correlation between SMI before neoadjuvant therapy (p = 0.5365) nor before surgery (p = 0.3530) with the short-term postoperative outcome. Regarding cholesterol level before surgery there was a trend for a higher risk of complications with lower cholesterol levels (p = 0.0846). Our findings suggest that a low preoperative SMI does not necessarily predict a poor postoperative outcome in esophageal cancer patients after esophagectomy but that there are many factors that influence the nutritional status of cancer patients. To improve nutritional status, cancer patients at our clinic receive specialized nutritional counselling during neoadjuvant treatment as well as after surgery.
View Full-Text
Keywords:
skeletal muscle index; esophagectomy; nutritional status; sarcopenia
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Grün, J.; Elfinger, L.; Le, H.; Weiß, C.; Otto, M.; Reißfelder, C.; Blank, S. The Influence of Pretherapeutic and Preoperative Sarcopenia on Short-Term Outcome after Esophagectomy. Cancers 2020, 12, 3409. https://doi.org/10.3390/cancers12113409
AMA Style
Grün J, Elfinger L, Le H, Weiß C, Otto M, Reißfelder C, Blank S. The Influence of Pretherapeutic and Preoperative Sarcopenia on Short-Term Outcome after Esophagectomy. Cancers. 2020; 12(11):3409. https://doi.org/10.3390/cancers12113409
Chicago/Turabian StyleGrün, Johanna, Lea Elfinger, Han Le, Christel Weiß, Mirko Otto, Christoph Reißfelder, and Susanne Blank. 2020. "The Influence of Pretherapeutic and Preoperative Sarcopenia on Short-Term Outcome after Esophagectomy" Cancers 12, no. 11: 3409. https://doi.org/10.3390/cancers12113409
Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.
