Sarcopenia and its Prognostic Value in Advanced Gastroesophageal Cancer

Article: Prognostic Value of Sarcopenia and Metabolic Parameters of 18F-FDG-PET/CT in Patients with Advanced Gastroesophageal Cancer

Esophageal, gastroesophageal, and gastric cancers make up a significant proportion of the global cancer burden. Associated with a poor prognosis and 5-year survival rate, up to half of patients present with an advanced stage of disease upon diagnosis, hindering the success of curative treatments. Fluorine-18-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) is a standard test with great diagnostic and prognostic value amongst patients with esophageal, gastroesophageal, and gastric cancers. Its inclusion of computed tomography facilitates the assessment of skeletal muscle, and thus, sarcopenia, in this patient population. Although sarcopenia has been shown to influence postoperative complications, its prognostic value for patients with advanced disease has not yet been characterised.

The aim of this study was to ascertain the prognostic value sarcopenia measurements and metabolic activity parameters of primary gastroesophageal cancer in patients with advanced metastatic disease.

Key learnings:

Sarcopenia (low skeletal muscle index (SMI) value) was found to be a prognostic marker for poor overall (OS) and progression-free survival (PFS) in patients with advanced, metastatic gastroesophageal cancer. Moreover, the use of sarcopenia status alongside clinical variables improved the prognostication of OS and PFS compared to clinical variables alone. Conversely, metabolic parameters from 18F-FDG-PET/CTs did not improve outcome prediction.

Reviewed by: S. Duarte

Authors: Hinzpeter R, Mirshahvalad SA, Kulanthaivelu R et al.

Published in: Diagnostics 2023