Obesity Clinical Trial
Official title:
An Investigation of the Prevalence and Clinical Impact of Sarcopenia and Visceral Obesity Among Patients With Upper Gastrointestinal Malignancies
In line with improvements in oncologic outcome for patients with esophageal cancer, the
attritional impact of curative treatment with respect to functional status and health-related
quality of life (HR-QL) in survivorship is increasingly an important focus. Functional
recovery after surgery for esophageal cancer is commonly confounded by anorexia and early
satiety, which may reduce oral nutrient intake with consequent malnutrition and weight loss.
One in three disease-free patients has more than fifteen percent body weight loss at three
years after esophagectomy.
The ESPEN Special Interest Group on cachexia-anorexia in chronic wasting diseases has defined
sarcopenia as skeletal muscle index (SMI) of ≤39 cm2/m2 for women and ≤55cm2/m2 for men,
while similar cut-off points have been validated in upper gastrointestinal and respiratory
malignancies (less than 38.5 cm2/m2 for women and 52.4 cm2/m2 for men). The European Working
Group on Sarcopenia in Older People (EWGSOP) additionally recommends that assessment should
also include determination of muscle function, for example gait speed or grip strength, where
possible.
The presence of sarcopenia is associated with increase treatment-associated morbidity,
impaired HR-QL, reduced physical and role functioning, and increased pain scores in older
adults. In addition, a previous longitudinal study demonstrated that the decline in HR-QL
over a six year period in older adults was accelerated in the presence of sarcopenia. As
such, sarcopenia may represent a modifiable barrier to recovery and subsequent retention of
HR-QL and functional status, and may reinforce a persistent illness identity, among patients
following potentially curative treatment for esophageal cancer.
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