Makoto Sakai, Takayoshi Watanabe, Kengo Kuriyama, Kohei Tateno, Mizuki Endo, Nobuhiro Nakazawa, Naoya Ozawa, Chika Komine, Takuhisa Okada, Takuya Shiraishi, Yuji Kumakura, Akiharu Kimura, Akihiko Sano, Takehiko Yokobori, Kazue Nagai, Ken Shirabe, Hiroshi Saeki
Regional variations in nutrient inadequacy were evident across Malawi, with the Central Region most affected by protein, lysine, and tryptophan inadequacy, followed by the Southern Region, although the Northern Region showed the lowest inadequacy. This highlights the need for region-specific interventions to address protein, lysine, and tryptophan inadequacy among children aged <5 y.
PURPOSE: The ratio of visceral fat area to psoas muscle area (V/P ratio) is a computed tomography (CT)-derived marker of visceral adiposity relative to skeletal muscle mass. We evaluated the prognostic value of the V/P ratio in patients with esophageal cancer undergoing definitive chemoradiotherapy (CRT).
METHODS: The subjects of this retrospective analysis were 73 patients treated with definitive CRT between 2008 and 2017. The V/P ratio was measured at the third lumbar vertebra on CT. We performed multivariate Cox regression for overall survival (OS) and cancer-specific survival (CSS).
RESULTS: The median V/P ratio was 5.31 (interquartile range, 2.60-9.46). The visceral fat area (p < 0.001), body mass index (BMI) (p < 0.001), proportion of patients with a Charlson comorbidity index (CCI) ≥ 1 (p = 0.001), and age-adjusted CCI (p = 0.003) were significantly associated with the V/P ratio. After adjustment for clinical factors, the V/P ratio was found to be an independent prognostic factor for OS (HR 2.11 per 1-SD increase; 95% CI, 1.35-3.29; p = 0.001) and CSS (HR 2.49; 95% CI, 1.55-4.00; p < 0.001). The association persisted in non-obese patients.
CONCLUSION: The V/P ratio was associated with poor OS for esophageal cancer patients receiving definitive CRT, even for those who were not obese.