Correlation of Tumor Sarcopenia and Cardiac Status in Patients With Esophageal Cancer Based on Cardiac Mri, Bioimpedance, and Ct

Background The 5-year survival rate for patients with esophageal tumors is 20%. In Western countries, without a screening program, tumors are frequently identified at a late stage, rendering curative treatment unfeasible. This is attributed to both the advanced stage of the tumor and the deteriorated general condition caused by tumor-related sarcopenia. This study attempts to clarify the relationship among body composition deterioration, sarcopenia, and alterations in cardiac status in malignant disease. Methods We conducted a prospective study involving 42 patients with stage II-III esophageal tumors prior to the beginning of their oncological treatment. The cardiac status was evaluated using cardiac MRI, while nutritional status and body composition were assessed through bioimpedance analysis (BIA). We determined the severity of sarcopenia by measuring the skeletal muscle area at the lumbar 3rd vertebrae (L3-SMA/SMI) via CT imaging. Results Correlation was identified among skeletal muscle loss, body composition, and alterations in cardiac status across several measured parameters. Body mass loss (p = 0.002, p = 0.002), skeletal muscle mass (p = 0.000009, p = 0.0004), protein mass (p = 000001, p = 0.0002), fat-free body mass index (p = 0.0001, p = 0.002), L3-SMA (p = 0.00000004, p = 0.000001), and SMI (p = 0.004, p = 0.005) were all significantly correlated with left ventricular (LV) muscle mass (LV Mass at End-Diastole and LV Mass at End-Diastole indexed to Height). There were significant correlations between LV End-Diastolic Volume, LV End-Systolic Volume, and LV Stroke Volume with skeletal muscle mass (p = 0.0007, p = 0.0001, p = 0.03), protein mass (p = 0.0003, p = 0.0003, p = 0.01), and L3 SMA (p = 0.004, p = 0.003, p = 0.01). Conclusion The study demonstrated that sarcopenia during tumor progression adversely affected skeletal muscle and body composition, as well as negatively influencing both morphological and functional parameters of the myocardium. The evaluation of cardiac status holds both prognostic significance and serves as a critical intervention point for guiding subsequent treatment decisions.