Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2023; 15(4): 621-633
Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.621
Skeletal muscle mass and quality before preoperative chemotherapy influence postoperative long-term outcomes in esophageal squamous cell carcinoma patients
Daichi Ichinohe, Takahiro Muroya, Harue Akasaka, Kenichi Hakamada
Daichi Ichinohe, Takahiro Muroya, Harue Akasaka, Kenichi Hakamada, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 0368562, Aomori, Japan
Author contributions: Ichinohe D contributed to conception, methodology, investigation, data curation, original drafting, reviewing, and editing of the manuscript, and generation of figures; Muroya T contributed to conception, methodology, data curation, and generation of figures; Akasaka H contributed to data curation; Hakamada K contributed to reviewing and editing of the manuscript, and supervised the study.
Institutional review board statement: The Institutional Review Board of Hirosaki University Hospital provided approval for this study (Approval No. 2020-038).
Informed consent statement: With regard to informed consent, Hirosaki University Hospital uses an opt-out format on its website and does not obtain individual consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: Data available upon reasonable request. Please contact daichii@hirosaki-u.ac.jp.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kenichi Hakamada, MD, PhD, Professor, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifucho, Hirosaki 0368562, Aomori, Japan. hakamada@hirosaki-u.ac.jp
Received: November 11, 2022
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

Esophageal cancer has a poor prognosis, and perioperative complications can be serious. It is important to consider prognostic factors in patients with esophageal cancer.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.