January 14, 2026Journal of Clinical Oncology0 citations

Impact of sarcopenia on short- and long-term outcomes after multimodal therapy for esophageal cancer.

LSLee Ann SantoreMayo Clinic KDKlevis DociUniversity of Medicine Tirana GAGrace Patrice Anyeti-AnumCleveland Clinic

Key Points

This research aims to evaluate the impact of sarcopenia on outcomes after multimodal therapy for esophageal cancer.
Retrospective observational cohort study of adult patients undergoing neoadjuvant therapy and esophagectomy for esophageal cancer.
Skeletal muscle index calculated using deep convolutional neural network from preoperative CT scans.
Chi-square tests used to explore relationships among sarcopenia, demographics, and complications.
Multivariable analysis performed to investigate sarcopenia's association with disease-free and overall survival.
142 out of 200 patients (71%) were classified as sarcopenic before surgery.
Sarcopenic patients had higher rates of blood transfusions (55.6% vs 13.8%) and surgical interventions (24.6% vs 12.1%) after esophagectomy.
Sarcopenia was identified as a significant prognostic factor affecting disease-free and overall survival.

Abstract

334 Background: Sarcopenia, or decreased skeletal muscle mass, has been associated with worse surgical and oncologic outcomes across multiple malignancies. This study investigates the impact of sarcopenia on outcomes after multimodal therapy for esophageal cancer. Methods: Retrospective observational cohort study including adult patients who underwent neoadjuvant therapy followed by esophagectomy for primary esophageal cancer from January 2000 - December 2021. A fully automated abdominal segmentation using deep convolutional neural network was utilized to calculate skeletal muscle index (SMI) from preoperative CT scans performed at our institution. Males with SMI .05). Sarcopenic patients were significantly more likely to require blood transfusion ≥3 units after esophagectomy [79 (55.6%) vs 8 (13.8%), p 3 pRBC - - 1.54 (0.99, 2.40) .057 BMI prior to cancer diagnosis - - 0.98 (0.94, 1.01 .208 Sarcopenic 1.76 (1.16, 2.67) .007 1.64 (1.04, 2.60) .033

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