Body composition in relation to postoperative anastomotic leakage and overall survival in patients with esophageal cancer

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 94; p. 111534
• Main Authors: Li, Shichao, Qiu, Ruixing, Yuan, Guanjie, Wang, Qi, Li, Zhen, Li, Qin, Zhang, Ni
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2022; Elsevier Limited
• Subjects: Abdomen; Adipose tissue; Anastomotic leak; Anastomotic Leak - diagnostic imaging; Anastomotic Leak - etiology; Anastomotic leakage; Biomarkers; Body Composition; Body fat; Body mass index; Body size; Cancer; Clinical medicine; Computed tomography; Esophageal cancer; Esophageal Neoplasms - surgery; Esophagus; Evaluation; Fistula; Fistulae; Hospitals; Humans; Intra-Abdominal Fat - diagnostic imaging; Medical prognosis; Medical records; Metabolism; Mortality; Multivariate analysis; Muscles; Musculoskeletal system; Obesity; Overall survival; Patients; Prognosis; Regression analysis; Retrospective Studies; Risk analysis; Risk assessment; Risk factors; Skeletal muscle; Smoking; Software; Subcutaneous fat index; Surgery; Survival; Vertebrae; Visceral fat index; United States > US; OS; Visceral fat index; SMA; SAT; VAT; AL; IFI; SMI; Anastomotic leakage; Subcutaneous fat index; SFI; VFI; Overall survival; EC; BMI
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2021.111534

•Patients with higher body mass index, visceral fat index, and subcutaneous fat index may have better overall survival.•Patients with higher visceral adipose tissue and visceral fat index were prone to postoperative anastomotic leakage.•Patients with higher visceral adipose tissue and visceral fat index were more difficult to heal from anastomotic leakage. Body composition was reported to be related to the prognosis of patients with cancer. This study aimed to investigate the influence of preoperative body composition on anastomotic leakage and overall survival in patients with esophageal cancer. In this retrospective study, 93 patients with esophageal cancers were evaluated. Skeletal muscle area, intermuscular adipose tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue were measured on computed tomography images at the level of the third lumbar vertebra. Subsequently, each body composition index was also calculated by dividing the body composition by the square of the height. The cut-off values of body compositions were defined using X-tile software (version 3.6.1; Yale University, New Haven, CTA). Univariate and multivariate analyses were performed to evaluate the risk factors of anastomotic leakage. Kaplan-Meier method and Cox regression analysis were used to evaluate the risk factors of overall survival. VAT and visceral fat index (VFI) were higher in patients with anastomotic fistula than in those without anastomotic fistula, but none of them were independent risk factors. Patients with higher body mass index (BMI), higher VFI, and higher subcutaneous fat index (SFI) had better overall survival. By multivariate analysis, SFI >27.6 cm2/m2 was still significantly associated with overall survival. Patients with higher VAT and VFI were prone to have an anastomotic leakage. Lower BMI, VFI, and SFI were associated with a reduction in overall survival.