Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.621
Peer-review started: November 11, 2022
First decision: January 23, 2023
Revised: February 8, 2023
Accepted: March 23, 2023
Article in press: March 23, 2023
Published online: April 27, 2023
Processing time: 163 Days and 3.1 Hours
Recently, muscle has been reported as an important prognostic factor. Not only muscle mass but also muscle quality has been reported to affect prognosis. Therefore, it is important to reveal how muscle composition is affected in patients undergoing preoperative chemotherapy for esophageal squamous cell carcinoma.
Esophageal cancer has a poor prognosis, and perioperative complications can be serious. It is important to consider prognostic factors in patients with esophageal cancer.
If body composition is a factor affecting prognosis, then preoperative chemotherapy and preoperative interventions can improve prognosis. In other words, a program to improve body composition before chemotherapy or before surgery can improve the prognosis of esophageal cancer patients. The objective was to determine the effect of muscle mass and quality on overall survival (OS) in esophageal squamous cell carcinoma.
In this study, we measured a cross-sectional area of the psoas muscle from computed tomography images. We evaluated muscle quality based on computed tomography values of the psoas muscle and subcutaneous fat. This was novel because both muscle mass and muscle quality were measured from the same image.
In this study, prognostic factors were found in patients who received preoperative chemotherapy for esophageal squamous cell carcinoma. Muscle mass as well as muscle quality and body composition before chemotherapy impacted disease-free survival and OS.
In this study, body composition was a prognostic factor for esophageal squamous cell carinoma patients. This suggests that muscle itself may be an immune system. Furthermore, the prognosis may be improved noninvasively if body composition is improved before chemotherapy or surgery.
Further studies are required to support our data. Randomized controlled trials to examine the prognostic change with and without the intervention of body composition improvement programs before chemotherapy and before surgery should be conducted.