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The effects of prehabilitation on body composition in patients undergoing multimodal therapy for esophageal cancer
Halliday, Laura Boshier, Piers R. Doganay, Emre Wynter-Blyth, Venetia Buckley, John P. Moorthy, Krishna
Halliday, Laura
Boshier, Piers R.
Doganay, Emre
Wynter-Blyth, Venetia
Buckley, John P.
Moorthy, Krishna
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EPub Date
Publication Date
2022-07-07
Submitted Date
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Abstract
Prehabilitation aims to optimize a patient’s functional capacity in preparation for surgery. Esophageal cancer patients have a high incidence of sarcopenia and commonly undergo neoadjuvant therapy, which is associated with loss of muscle mass. This study examines the effects of prehabilitation on body composition during neoadjuvant therapy in esophageal cancer patients. In this cohort study, changes in body composition were compared between esophageal cancer patients who participated in prehabilitation during neoadjuvant therapy and controls who did not receive prehabilitation. Assessment of body composition was performed from CT images acquired at the time of diagnosis and after neoadjuvant therapy. Fifty-one prehabilitation patients and 28 control patients were identified. There was a significantly greater fall in skeletal muscle index (SMI) in the control group compared with the prehabilitation patients (Δ SMI mean difference = −2.2 cm2/m2, 95% CI –4.3 to −0.1, p=0.038). Within the prehabilitation cohort, there was a smaller decline in SMI in patients with ≥75% adherence to exercise in comparison to those with lower adherence (Δ SMI mean difference = −3.2, 95% CI –6.0 to −0.5, P = 0.023). A greater decrease in visceral adipose tissue (VAT) was seen with increasing volumes of exercise completed during prehabilitation (P = 0.046). Loss of VAT during neoadjuvant therapy was associated with a lower risk of post-operative complications (P = 0.017). By limiting the fall in SMI and promoting VAT loss, prehabilitation may have multiple beneficial effects in patients with esophageal cancer. Multi-center, randomized studies are needed to further explore these findings.
Citation
Halliday, L., Boshier, P. R., Doganay, E., Wynter-Blyth, V., Buckley, J. P., & Moorthy, K. (2023). The effects of prehabilitation on body composition in patients undergoing multimodal therapy for esophageal cancer. Diseases of the Esophagus, 36(2), doac046. https://doi.org/10.1093/dote/doac046
Publisher
Oxford University Press
Journal
Diseases of the Esophagus
Research Unit
DOI
10.1093/dote/doac046
PubMed ID
PubMed Central ID
Type
Article
Language
Description
Series/Report no.
ISSN
1120-8694
EISSN
1442-2050