Low skeletal muscle mass in stented esophageal cancer predicts poor survival : A retrospective observational study

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Järvinen , T , Ilonen , I , Kauppi , J , Volmonen , K , Salo , J & Räsänen , J 2018 , ' Low skeletal muscle mass in stented esophageal cancer predicts poor survival : A retrospective observational study ' , Thoracic cancer , vol. 9 , no. 11 , pp. 1429-1436 . https://doi.org/10.1111/1759-7714.12855

Title: Low skeletal muscle mass in stented esophageal cancer predicts poor survival : A retrospective observational study
Author: Järvinen, Tommi; Ilonen, Ilkka; Kauppi, Juha; Volmonen, Kirsi; Salo, Jarmo; Räsänen, Jari
Contributor: University of Helsinki, Department of Surgery
University of Helsinki, Department of Surgery
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Clinicum
University of Helsinki, III kirurgian klinikka
Date: 2018-11
Language: eng
Number of pages: 8
Belongs to series: Thoracic cancer
ISSN: 1759-7706
URI: http://hdl.handle.net/10138/273458
Abstract: Background Methods In esophageal cancer, nutritional challenges are extremely common. Malignant obstruction resulting from esophageal cancer (EC) is often treated by the insertion of expandable stents, but little is known as to the role and evolution of sarcopenia in this patient population. The aim of this article was to determine the effects of body mass parameters on survival of advanced EC patients who received a stent for palliation of malignant obstruction. This was a retrospective observational study of 238 EC patients who had a stent inserted for palliation of malignant obstruction between 2005 and 2013. Skeletal muscle mass was calculated from abdominal computed tomography scans, and the patients were divided into sarcopenic and non-sarcopenic groups. A follow-up computed tomography scan was available in 118 patients. The primary outcome was survival, and complication rates and the need for an alternative enteral feeding route were secondary outcomes. Results Conclusions Sarcopenia occurred in 199 (85%) patients. Median survival was 146 (range: 76-226) days in the sarcopenia group and 152 (range: 71-249) days in the non-sarcopenic group (P = 0.61). Complication rates between the groups were not significantly different (P = 0.85). In Cox regression analysis, the skeletal muscle index was inversely correlated with overall survival (hazard ratio 0.98, 95% confidence interval 0.97-0.99; P = 0.033). Sarcopenia, defined by consensus thresholds, at the time of stent insertion cannot effectively predict poor survival in this patient cohort, but a lower skeletal muscle index correlates with poor prognosis as a continuous variable.
Subject: Esophageal neoplasm
esophageal stent
sarcopenia
swallowing disorder
GASTROESOPHAGEAL JUNCTION
CLINICAL-IMPLICATIONS
CONTROLLED-TRIAL
METAL STENT
SARCOPENIA
TOXICITY
CACHEXIA
DEFINITION
CHEMOTHERAPY
DETERMINANT
3122 Cancers
3121 General medicine, internal medicine and other clinical medicine
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