Does preoperative sarcopenia in esophageal cancer affect short-term outcomes in patients with esophageal cancer?

Abstract Purpose Sarcopenia is a condition in which muscle mass decreases with age. With the aging of society, the number of cancer cases is increasing, as is the number of sarcopenia cases. Many studies have investigated the relationship between sarcopenia and postoperative survival in patients with cancer; however, the diagnostic criteria for sarcopenia varied among the studies. Using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria to diagnose sarcopenia, this study investigated the impact of preoperative sarcopenia on the short-term outcomes of patients with esophageal squamous cell carcinoma (ESCC). Methods Ninety-two Japanese patients (73 men and 19 women) with ESCC who underwent radical esophagectomy were retrospectively reviewed. The association between sarcopenia and demographic, nutritional, and clinicopathologic factors was investigated. Survival was assessed via Kaplan–Meier analysis, and factors affecting overall survival (OS) and recurrence-free survival were identified via regression analysis. Results Patients with preoperative sarcopenia (n = 11) had a significantly lower body mass index and lost more blood during surgery than did patients without sarcopenia (n = 81). Age, sex, respiratory function, and nutritional status were not associated with sarcopenia. Recurrence rates did not differ between patients with vs. without sarcopenia, whereas deaths were significantly more frequent in patients with sarcopenia. Sarcopenia and higher pathological stage independently predicted worse OS. Conclusions Preoperative sarcopenia diagnosed according to the AWGS 2019 criteria negatively influences short-term outcomes in patients with ESCC.