Change in PMI During Neoadjuvant Therapy Is a Predictive Prognostic Marker in Rectal Cancer

Background/Aim: Neoadjuvant therapy is often administered to patients with locally advanced rectal cancer (LARC). The aim of this study was to investigate the correlation between the change in the psoas muscle index (PMI) during neoadjuvant therapy and the prognosis of LARC patients. Patients and Methods: Forty-seven patients who underwent potentially curative surgery for LARC with neoadjuvant therapy were enrolled in this study. We evaluated the relationship between the prognosis and clinicopathological factors, including the prognostic value of a change in the PMI. Results: A >10% decrease in the PMI value was observed in 15 of the 47 patients. A >10% decrease in the PMI value was associated with shorter OS and RFS compared to patients who did not show a >10% decrease in their PMI. The decrease in PMI after neoadjuvant therapy was an independent negative prognostic factor for patients undergoing neoadjuvant therapy for LARC. Conclusion: A decrease in PMI after neoadjuvant therapy might predict a poor prognosis in LARC patients undergoing neoadjuvant therapy.

[1]  T. Fujiwara,et al.  Radiographic sarcopenia predicts postoperative infectious complications in patients undergoing pancreaticoduodenectomy , 2017, BMC Surgery.

[2]  Zhao Zhang,et al.  Impact of different sarcopenia stages on the postoperative outcomes after radical gastrectomy for gastric cancer , 2017, Surgery.

[3]  M. Yashiro,et al.  Adverse Effects of Low Preoperative Skeletal Muscle Mass in Patients Undergoing Gastrectomy for Gastric Cancer , 2017, Annals of Surgical Oncology.

[4]  J. V. van Lanschot,et al.  Sarcopenia/Muscle Mass is not a Prognostic Factor for Short- and Long-Term Outcome After Esophagectomy for Cancer , 2016, World Journal of Surgery.

[5]  K. Katanoda,et al.  Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project. , 2015, Japanese journal of clinical oncology.

[6]  Y. Sakai,et al.  Outcomes of Neoadjuvant Chemotherapy without Radiation for Rectal Cancer , 2015, Digestive Surgery.

[7]  Y. Sakamoto,et al.  Negative Impact of Skeletal Muscle Loss after Systemic Chemotherapy in Patients with Unresectable Colorectal Cancer , 2015, PloS one.

[8]  M. Mizumoto,et al.  Impact of preoperative quality as well as quantity of skeletal muscle on survival after resection of pancreatic cancer. , 2015, Surgery.

[9]  M. Sosef,et al.  Loss of Skeletal Muscle Mass During Neoadjuvant Chemoradiotherapy Predicts Postoperative Mortality in Esophageal Cancer Surgery , 2015, Annals of Surgical Oncology.

[10]  J. Cheville,et al.  Sarcopenia in patients with bladder cancer undergoing radical cystectomy: Impact on cancer‐specific and all‐cause mortality , 2014, Cancer.

[11]  S. Noble,et al.  The assessment and impact of sarcopenia in lung cancer: a systematic literature review , 2014, BMJ Open.

[12]  G. Spolverato,et al.  Sarcopenia Adversely Impacts Postoperative Complications Following Resection or Transplantation in Patients with Primary Liver Tumors , 2014, Journal of Gastrointestinal Surgery.

[13]  T. Yamanaka,et al.  Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma , 2013, The British journal of surgery.

[14]  J. Kenig,et al.  Definition of the rectum and level of the peritoneal reflection – still a matter of debate? , 2013, Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques.

[15]  M. Winget,et al.  Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery , 2012, British Journal of Cancer.

[16]  W. Hohenberger,et al.  Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  J. Baeyens,et al.  European working group on sarcopenia in older people. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people , 2010 .

[18]  L. Schwartz,et al.  New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). , 2009, European journal of cancer.

[19]  Bernard Leduc,et al.  Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Laurence Collette,et al.  Chemotherapy with preoperative radiotherapy in rectal cancer. , 2006, The New England journal of medicine.

[21]  R. Heald,et al.  Defining the rectum: surgically, radiologically and anatomically , 2006, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[22]  R. Glynne-Jones,et al.  A phase I/II study of oxaliplatin when added to 5-fluorouracil and leucovorin and pelvic radiation in locally advanced rectal cancer: a Colorectal Clinical Oncology Group (CCOG) study , 2005, British Journal of Cancer.

[23]  N. Demartines,et al.  Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey , 2004, Annals of Surgery.