Marked changes in body composition following neoadjuvant chemotherapy for oesophagogastric cancer

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 31; no. 1; pp. 74 - 77
• Main Authors: Awad, Sherif, Tan, Benjamin H, Cui, Helen, Bhalla, Ashish, Fearon, Kenneth C.H, Parsons, Simon L, Catton, James A, Lobo, Dileep N
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.02.2012; Elsevier
• Subjects: Aged; Biological and medical sciences; Body Composition; Cancer; Chemotherapy; computer software; fat free mass; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastric; Gastroenterology and Hepatology; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - therapy; Hospitalization; hospitals; Humans; image analysis; Length of Stay; Male; males; Middle Aged; mortality; Neoadjuvant Therapy - adverse effects; Obesity - epidemiology; Oesophageal; Outcomes; patients; Pilot Projects; Postoperative Care - methods; Prevalence; Sarcopenia; Sarcopenia - chemically induced; Sarcopenia - complications; Sarcopenia - epidemiology; Surgery; toxicity; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Oesophageal; FM; fat mass; FFM; Body composition; Outcomes; Sarcopenia; skeletal muscle index; Surgery; BMI; CF; fat free mass; body mass index; cisplatinum/fluorouracil; ECF; OGC; SMI; NAC; neoadjuvant chemotherapy; Chemotherapy; eicosapentaenoic acid; epirubicin/cisplatin/5-fluorouracil; EPA; Gastric; Cancer; oesophagogastric cancer; Treatment; Metabolic diseases; Malignant tumor; Neoadjuvant treatment
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2011.08.008

Summary Background & aims Patients with sarcopenia [reduced fat free mass (FFM)] have a higher incidence of chemotherapy-related toxicity and decreased survival. As there are no such data in patients with oesophagogastric cancer (OGC), this study investigated changes in body composition in OGC patients receiving neoadjuvant chemotherapy (NAC). Methods OGC patients who had CT scans before and after NAC were studied. CT images at the L3 vertebral level were analysed using SliceOmatic® software to derive estimates of FFM and fat mass (FM). Comparisons were made between pre- and post-NAC CT images. Data are reported as mean ± SD. Results Forty-seven patients (34 male) aged 63 ± 12 years were studied and 79% completed their course of NAC. The interval between CT scans was 107 ± 27 days. The proportion of patients with sarcopenia increased from 57% pre-NAC to 79% post-NAC ( p  = 0.046). During NAC there were significant reductions in estimated FFM and FM (2.9 ± 4.7 kg, p  < 0.0001 and 1.3 ± 3.2 kg, p  = 0.007, respectively). No association was demonstrated between loss of FFM and non-completion of NAC, increased hospital stay or mortality. Conclusions In patients with OGC commencing NAC, sarcopenia was present in 57%. NAC was associated with further reductions in FFM and an increase in the proportion of patients becoming sarcopenic.