Gastrointestinal Cancer

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SU_6_2053 - Sarcopenia is associated with inferior response to neoadjuvant chemoradiation in patients with locally advanced rectal cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Sarcopenia is associated with inferior response to neoadjuvant chemoradiation in patients with locally advanced rectal cancer
J. Y. WU1, C. C. Kuo1, L. L. Ting1, L. J. Kuo2, H. L. Lee1, Y. Huang1, C. J. Cheng3, J. F. Chiou1,4, and L. S. Lu1,5; 1Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan, 2Department of surgery, Taipei Medical University Hospital, Taipei, Taiwan, 3Department of pathology, Taipei Medical University Hospital, Taipei, Taiwan, 4Taipei Cancer Center, Taipei Medical University Hospital, Taipei, Taiwan, 5Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan

Purpose/Objective(s): Sarcopenia is associated with treatment toxicity and inferior overall survival in many solid tumors. However its impact on radiotherapy response is unclear. We conducted an investigation to test the association between sarcopenia and response of neoadjuvant chemoradiation in patients with locally advanced rectal cancer (LARC).

Materials/Methods: This is a single institute study. 176 patients with rectal cancer were retrospectively included between 2011 and 2017. Neoadjuvant chemoradiation was followed by curative resection. Skeletal muscle index (SMI) was calculated by body height-corrected skeletal muscle mass area at the third level of lumbar vertebra on pretreatment simulation computer tomography scans. Gender-specific cutoff of SMI for sarcopenia was defined as the value equal to mean – 1 standard deviation in this population. The 2010 American Joint Committee on Cancer tumor response grading (TRG) system was used to report treatment response on protectomy samples, and a treatment response was defined as TRG 0 or TRG 1. Multivariate logistic regression analysis was used to determine statistical significance of the observed association.

Results: Among the 176 patients, 45 (25.5%) patients were sarcopenic. The body mass index (average ±standard error of mean) was 24.05 ± 0.03 for men and 24.20 ± 0.07 for women. 93 (52.8%) patients showed a treatment response to neoadjuvant chemoradiation, and within this group 33 (18.2%) patients were classified as TRG 0. In univariate analysis, statically significant predictors of treatment response include age, clinical T stage, sarcopenia and the distance between tumor and anal verge. Sacropenia and clinical T stage remained statistically significant (odds ratio: 2.83 and 2.11, p ≤ 0.05) in the multivariate analysis.

Conclusion: Our data suggest that sarcopenia is independently associated with poor chemoradiation response in patients with LARC. Further multi-institutional study is warranted to validate this finding and to define a universally prognostic SMI cutoff for patients with LARC.

Author Disclosure: J. WU: None. C. Kuo: None. L. Ting: None. Y. Huang: None.

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