Y. Nakashima1, H. Saeki1, R. Nakanishi1, M. Sugiyama1, J. Kurashige1, E. Oki1, Y. Maehara1 1Kyushu University,Department Of Surgery And Science,Fukuoka, FUKUOKA, Japan
Introduction:
The present study investigated the effect of sarcopenia on short-and long-term surgical outcomes and identified potential prognostic factors for esophageal cancer among patients 65 years of age and older.
Methods:
Patient data were retrospectively collected for 341 consecutive patients who underwent esophagectomy for esophageal cancer. Patients were assigned to two groups according to age (younger than 65 years and 65 years and older), and the presence of sarcopenia. The clinicopathological, surgical outcome, and long-term survival data were analyzed.
Results:
Sarcopenia was present in 170 of 341 patients (49.9%) with esophageal cancer, and 48.5% of patients aged 65 years and older. The incidence of anastomotic leak and in-hospital death were significantly higher in elderly sarcopenia group than in elderly non-sarcopenia group (30.1% versus 16.3%, 6.8% versus 0.0%, respectively). Overall survival rate in patients with sarcopenia correlated with significantly poor prognosis in the group aged 65 years and older (p<0.001). Multivariate analysis revealed that sarcopenia was predictive of anastomotic leak and unfavorable prognosis in the group aged 65 years and older. On the other hand, both of the incidence of surgical complications and overall survival rate were similar between sarcopenia and non-sarcopenia in patients younger than 65.
Conclusion:
This retrospective analysis revealed that sarcopenia was a risk factor for anastomotic leak and a prognostic marker of overall survival after esophagectomy in patients 65 years of age and older with esophageal cancer.