Examination of fatty infiltration of skeletal muscles by CT value in the evaluation of sarcopenia during preoperative chemotherapy for esophageal cancery

Abstract

Sarcopenia was associated with postoperative complications and poor prognosis in various cancers. We aimed to evaluate quantitative and qualitative changes by using computed tomography ‹CT› during preoperative chemotherapy. We retrospectively reviewed 60 patients who received preoperative chemotherapy, followed by esophagectomy. We assessed the change in muscle mass and CT value of the bilateral iliopsoas and erector spinae muscles before and after chemotherapy and examined how these changes affect the postoperative period. The area of iliopsoas muscles significantly decreased between before and after chemotherapy ‹1217.3 ± 417.5 vs. 1123.4 ± 354.6, p < 0.001›. Meanwhile, there was no significant difference in the area of the erector spinae muscles. Although there was no significant difference in the CT value of iliopsoas muscles between before and after chemotherapy, the CT value of the erector spinae muscle significantly decreased ‹44.2 ± 11.6 vs. 42.5 ± 11.4, p = 0.015›. Our results indicated that chemotherapy might have a different effect on different muscles. It was suggested that the assessment of sarcopenia requires not only the assessment of muscle mass but also the assessment of fatty infiltration. We developed a simple and quantitative method to evaluate sarcopenia during preoperative chemotherapy by assessing CT value.