Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

Connie Yip; Vicky Goh; Andrew Davies; James Gossage; Rosalind Mitchell-Hay; Orla Hynes; Nick Maisey; Paul Ross; Andrew Gaya; David B. Landau; Gary J. Cook; Nyree Griffin; Robert Mason

doi:10.1007/s00330-014-3110-4

Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

Connie Yip^*, Vicky Goh, Andrew Davies, James Gossage, Rosalind Mitchell-Hay, Orla Hynes, Nick Maisey, Paul Ross, Andrew Gaya, David B. Landau, Gary J. Cook, Nyree Griffin, Robert Mason

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

173 Citations (Scopus)

Abstract

Objectives: Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. Methods: A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Results: Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 %±6.4 (SD) in comparison to FM index (-1.2±4.2), FFM index (-4.6±6.8), FMR (-1.2±24.3) and VA/SA (-62.3±12.7). Changes in FM index (p=0.022), FMR (p=0.028), VA/SA (p=0.024) and weight (p=0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Conclusions: Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. Key Points: • Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer. • Sarcopenia was more prevalent after neoadjuvant chemotherapy. • Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy. • Changes in body composition were associated with CRM positivity. • Changes in body composition did not affect perioperative complications and survival.

Original language	English
Pages (from-to)	998-1005
Number of pages	8
Journal	European Radiology
Volume	24
Issue number	5
DOIs	https://doi.org/10.1007/s00330-014-3110-4
Publication status	Published - 18 Feb 2014

Bibliographical note

Funding Information:
The scientific guarantor of this publication is Prof. Vicky Goh. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Department of Health via the National Institute of Health Research Biomedical Research Centre award to Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust; and from the Comprehensive Cancer Imaging Centre, funded by the Cancer Research UK and Engineering and Physical Sciences Research Council in association with the Medical Research Council and Department of Health. Dr. Connie Yip receives funding support from the National Medical Research Council, Singapore. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was not required for this study because anonymised patient data was used with no intervention or patient contact. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

Copyright: European Society of Radiology 2014

Keywords

Body composition
Neoadjuvant chemotherapy
Oesophageal cancer
Sarcopenia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00330-014-3110-4

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Yip, C., Goh, V., Davies, A., Gossage, J., Mitchell-Hay, R., Hynes, O., Maisey, N., Ross, P., Gaya, A., Landau, D. B., Cook, G. J., Griffin, N., & Mason, R. (2014). Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer. European Radiology, 24(5), 998-1005. https://doi.org/10.1007/s00330-014-3110-4

Yip, C, Goh, V, Davies, A, Gossage, J, Mitchell-Hay, R, Hynes, O, Maisey, N, Ross, P, Gaya, A, Landau, DB, Cook, GJ, Griffin, N & Mason, R 2014, 'Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer', European Radiology, vol. 24, no. 5, pp. 998-1005. https://doi.org/10.1007/s00330-014-3110-4

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title = "Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer",

abstract = "Objectives: Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. Methods: A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Results: Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 %±6.4 (SD) in comparison to FM index (-1.2±4.2), FFM index (-4.6±6.8), FMR (-1.2±24.3) and VA/SA (-62.3±12.7). Changes in FM index (p=0.022), FMR (p=0.028), VA/SA (p=0.024) and weight (p=0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Conclusions: Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. Key Points: • Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer. • Sarcopenia was more prevalent after neoadjuvant chemotherapy. • Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy. • Changes in body composition were associated with CRM positivity. • Changes in body composition did not affect perioperative complications and survival.",

keywords = "Body composition, Neoadjuvant chemotherapy, Oesophageal cancer, Sarcopenia",

author = "Connie Yip and Vicky Goh and Andrew Davies and James Gossage and Rosalind Mitchell-Hay and Orla Hynes and Nick Maisey and Paul Ross and Andrew Gaya and Landau, {David B.} and Cook, {Gary J.} and Nyree Griffin and Robert Mason",

note = "Funding Information: The scientific guarantor of this publication is Prof. Vicky Goh. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Department of Health via the National Institute of Health Research Biomedical Research Centre award to Guy{\textquoteright}s and St Thomas{\textquoteright} NHS Foundation Trust in partnership with King{\textquoteright}s College London and King{\textquoteright}s College Hospital NHS Foundation Trust; and from the Comprehensive Cancer Imaging Centre, funded by the Cancer Research UK and Engineering and Physical Sciences Research Council in association with the Medical Research Council and Department of Health. Dr. Connie Yip receives funding support from the National Medical Research Council, Singapore. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was not required for this study because anonymised patient data was used with no intervention or patient contact. Methodology: retrospective, diagnostic or prognostic study, performed at one institution. Copyright: European Society of Radiology 2014",

year = "2014",

month = feb,

day = "18",

doi = "10.1007/s00330-014-3110-4",

language = "English",

volume = "24",

pages = "998--1005",

journal = "European Radiology",

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TY - JOUR

T1 - Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

AU - Yip, Connie

AU - Goh, Vicky

AU - Davies, Andrew

AU - Gossage, James

AU - Mitchell-Hay, Rosalind

AU - Hynes, Orla

AU - Maisey, Nick

AU - Ross, Paul

AU - Gaya, Andrew

AU - Landau, David B.

AU - Cook, Gary J.

AU - Griffin, Nyree

AU - Mason, Robert

N1 - Funding Information: The scientific guarantor of this publication is Prof. Vicky Goh. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Department of Health via the National Institute of Health Research Biomedical Research Centre award to Guy’s and St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust; and from the Comprehensive Cancer Imaging Centre, funded by the Cancer Research UK and Engineering and Physical Sciences Research Council in association with the Medical Research Council and Department of Health. Dr. Connie Yip receives funding support from the National Medical Research Council, Singapore. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was not required for this study because anonymised patient data was used with no intervention or patient contact. Methodology: retrospective, diagnostic or prognostic study, performed at one institution. Copyright: European Society of Radiology 2014

PY - 2014/2/18

Y1 - 2014/2/18

N2 - Objectives: Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. Methods: A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Results: Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 %±6.4 (SD) in comparison to FM index (-1.2±4.2), FFM index (-4.6±6.8), FMR (-1.2±24.3) and VA/SA (-62.3±12.7). Changes in FM index (p=0.022), FMR (p=0.028), VA/SA (p=0.024) and weight (p=0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Conclusions: Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. Key Points: • Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer. • Sarcopenia was more prevalent after neoadjuvant chemotherapy. • Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy. • Changes in body composition were associated with CRM positivity. • Changes in body composition did not affect perioperative complications and survival.

AB - Objectives: Sarcopenia and changes in body composition following neoadjuvant chemotherapy (NAC) may affect clinical outcome. We assessed the associations between CT body composition changes following NAC and outcomes in oesophageal cancer. Methods: A total of 35 patients who received NAC followed by oesophagectomy, and underwent CT assessment pre- and post-NAC were included. Fat mass (FM), fat-free mass (FFM), subcutaneous fat to muscle ratio (FMR) and visceral to subcutaneous adipose tissue ratio (VA/SA) were derived from CT. Changes in FM, FFM, FMR, VA/SA and sarcopenia were correlated to chemotherapy dose reductions, postoperative complications, length of hospital stay (LOS), circumferential resection margin (CRM), pathological chemotherapy response, disease-free survival (DFS) and overall survival (OS). Results: Nine (26 %) patients were sarcopenic before NAC and this increased to 15 (43 %) after NAC. Average weight loss was 3.7 %±6.4 (SD) in comparison to FM index (-1.2±4.2), FFM index (-4.6±6.8), FMR (-1.2±24.3) and VA/SA (-62.3±12.7). Changes in FM index (p=0.022), FMR (p=0.028), VA/SA (p=0.024) and weight (p=0.007) were significant univariable factors for CRM status. There was no significant association between changes in body composition and survival. Conclusions: Loss of FM, differential loss of VA/SA and skeletal muscle were associated with risk of CRM positivity. Key Points: • Changes in CT body composition occur after neoadjuvant chemotherapy in oesophageal cancer. • Sarcopenia was more prevalent after neoadjuvant chemotherapy. • Fat mass, fat-free mass and weight decreased after neoadjuvant chemotherapy. • Changes in body composition were associated with CRM positivity. • Changes in body composition did not affect perioperative complications and survival.

KW - Body composition

KW - Neoadjuvant chemotherapy

KW - Oesophageal cancer

KW - Sarcopenia

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U2 - 10.1007/s00330-014-3110-4

DO - 10.1007/s00330-014-3110-4

M3 - Article

C2 - 24535076

AN - SCOPUS:84898820718

SN - 0938-7994

VL - 24

SP - 998

EP - 1005

JO - European Radiology

JF - European Radiology

IS - 5

ER -

Assessment of sarcopenia and changes in body composition after neoadjuvant chemotherapy and associations with clinical outcomes in oesophageal cancer

Abstract

Bibliographical note

Keywords

UN SDGs

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