288. POST-OPERATIVE COMPLICATIONS IN OBESE SARCOPENIC PATIENTS WITH ESOPHAGOGASTRIC ADENOCARCINOMA UNDERGOING NEOADJUVANT CHEMOTHERAPY

Abstract

Abstract Background Sarcopenia is defined as a loss of skeletal muscle mass and function. Preoperative sarcopenia amongst patients with esophageal cancer has been linked to mortality, various postoperative complications and the severity of these complications. Obesity has been linked with many health problems. Evidence has not been previously published regarding complication rates in obese, sarcopenic patients with esophagogastric adenocarcinoma undergoing neoadjuvant chemotherapy. Methods Patients diagnosed with EGA between January 2017 and December 2021 and undergoing NAC followed by esophagectomy from a single high-volume center had their post-NAC CT scans assessed for radiological sarcopenia. Skeletal muscle index (SMI) was calculated from muscle area measured on CT scans at the level of third lumbar vertebra. Previously published SMI cut off values of 52.4 cm2 for men and 38.5 cm2 for women were used. Obesity was defined as a BMI >30 kg/m2. Post-operative complications were prospectively collected and classified using the Clavien-Dindo (CD) classification system. Patients were grouped as CD 0-I (no-mild complications) or CD II-V (moderate–severe complications). Results There were 191 patients included in the analysis. 25 patients post-NAC were both sarcopenic and obese. There was no significant difference between complication rates in the obese sarcopenic group vs the sarcopenic group. Conclusion EGA patients with obesity and sarcopenia post-NAC do not have a higher chance of developing complications than those patients with just sarcopenia.