Abstract

Abstract Background Sarcopenia is defined as a loss of skeletal muscle mass and function. Preoperative sarcopenia amongst patients with esophageal cancer is known to be associated with post-operative complications and increased mortality. Whether preoperative sarcopenia has an affect on disease recurrence has not been investigated for patients with esophageal 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. Patients that had complete resection (R0) of were included in the analysis. A cox-regression model was used to investigate recurrence between those with sarcopenia and those without. Results 133 patients were included in the analysis. Patients with sarcopenia before or after NAC were not more likely to develop disease recurrence than those patients without sarcopenia (Hazard ratio 1.08, 95% CI 0.97–1.17; p > 0.05). Conclusion In this cohort of patients from a single high volume centre, sarcopenia status in EGA patients undergoing NAC and esophagectomy does not significantly impact the rate of disease recurrence.

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