Kotaro Sugawara, Shinichiro Shiomi, Wataru Gonoi, Satoru Taguchi, Shouhei Hanaoka, Koichi Yagi, Osamu Abe, Haruki Kume, Yoshifumi Baba
The prognostic implications of the BC parameters may vary by age and sex in patients with gastroesophageal cancer.
PURPOSE: This study aimed to evaluate the sex- and age-specific survival impacts of body composition (BC) parameters in patients with surgically treated gastroesophageal cancer.
METHODS: A total of 1382 patients were retrospectively analyzed. The skeletal muscle index (SMI), skeletal muscle radiodensity (SMD), and visceral/subcutaneous adipose tissue index (VATI/SATI) were determined. The survival impacts of the BC parameters were investigated according to age (≥ 75 or < 75 years) and sex. Multivariate Cox hazard models were used to identify independent predictors of a poor overall survival (OS) and cancer-specific survival (CSS).
RESULTS: The median age was 67 years, and 1028 (74.4%) patients were male. A low SMI (P < 0.001), a low SATI (P = 0.048), and a low SMD (P = 0.01) were independent predictors of poor OS in younger patients; however, only a low SMI (P < 0.001) had an independent impact on OS in the older group. In male patients, all four BC measures significantly demarcated OS curves (all P < 0.01), and a low SMI had an independent impact on CSS (P = 0.03). In contrast, in female patients, only SMI and SATI reliably discriminated OS curves (both P < 0.001), and a low SATI was an independent predictor of a poor CSS (P = 0.008).
CONCLUSIONS: The prognostic implications of the BC parameters may vary by age and sex in patients with gastroesophageal cancer.