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Published on: February 21, 2025
Osteosarcopenia as a Predictor of Histopathologic Response to Neoadjuvant Chemoradiotherapy in Esophageal Cancer: a
Yuki Hirase1, Ken Sasaki2, Yusuke Tsuruda1
1Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima-shi, 890-8520, Japan.
Purpose:
Predicting chemoradiotherapy (CRT) response in esophageal cancer is essential as outcomes vary among patients. This study aimed to evaluate the impact of osteosarcopenia on the effectiveness of neoadjuvant CRT (NACRT).
Methods:
Ninety-five patients with advanced esophageal cancer who underwent surgical resection post-NACRT were included. Sarcopenia and osteopenia were determined using pre-NACRT skeletal muscle index and bone density at L3 and Th11 levels. Patients were categorized based on osteosarcopenia status.
Results:
Thirty-seven patients (39%) had osteosarcopenia. Among tumors, 49 (51.6%) were grade 1 (non-responders), 12 (12.6%) were grade 2, and 34 (35.8%) were grade 3 (responders). NACRT was significantly more effective in patients with above-median body mass index, shallow tumor depth, low squamous cell carcinoma antigen levels, and without osteosarcopenia. Osteosarcopenia was independently correlated with the histopathologic response to NACRT. No significant differences in overall or relapse-free survival were observed based on osteosarcopenia status.
Conclusion:
Osteosarcopenia may predict NACRT response in esophageal cancer.
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