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Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor
Yasuhiro Shirakawa
"Okayama Daigaku Daigakuin Ishiyakugaku Sogo Kenkyuka Igakubu"
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4698-5119
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Background: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery.
Methods: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and June 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and three days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model.
Results: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The three-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group.
Conclusion: skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.
Keywords
Esophageal cancer, Sarcopenia, Skeletal muscle loss
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CURRENT STATUS: Published
Version 2
Posted 09 Jun, 2020
Published
On 26 Jun, 2020
No community comments so far
Editorial decision: Accept
On 05 Jun, 2020
Editor assigned
On 03 Jun, 2020
Submission checks complete
On 02 Jun, 2020
Editor invited
On 02 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 07 May, 2020
Review #2 received
Received 06 May, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 04 Mar, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
First submitted
On 08 Feb, 2020
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Subject Areas
Oncology
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor
Yasuhiro Shirakawa
"Okayama Daigaku Daigakuin Ishiyakugaku Sogo Kenkyuka Igakubu"
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4698-5119
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 09 Jun, 2020
Published
On 26 Jun, 2020
No community comments so far
Editorial decision: Accept
On 05 Jun, 2020
Editor assigned
On 03 Jun, 2020
Submission checks complete
On 02 Jun, 2020
Editor invited
On 02 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 07 May, 2020
Review #2 received
Received 06 May, 2020
Reviewer #2 agreed
On 30 Mar, 2020
Review #1 received
Received 04 Mar, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
First submitted
On 08 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Surgical Oncology.
Background: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery.
Methods: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and June 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and three days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model.
Results: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The three-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group.
Conclusion: skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.
Figure 1
Figure 2
Figure 3
Figure 4
Due to technical limitations, tables 1-4 are only available as downloads in the supplementary files.