Impact on postoperative complications of changes in skeletal muscle mass during neoadjuvant chemotherapy for gastro-oesophageal cancer

Background: Risk assessment is relevant to predict postoperative outcomes in patients with gastro-oesophageal cancer. This cohort study aimed to assess body composition changes during neoadjuvant chemotherapy and investigate their association with postoperative complications. Methods: Consecutive patients with gastro-oesophageal cancer undergoing neoadjuvant chemotherapy and surgery with curative intent between 2016 and 2019 were identified from a specific database and included in the study. CT images before and after neoadjuvant chemotherapy were used to assess the skeletal muscle index, sarcopenia, and subcutaneous and visceral fat index. Results: In a cohort of 199 patients, the mean skeletal muscle index decreased during neoadjuvant therapy (from 51.187 to 49.19 cm(2)/m(2); P < 0.001) and the rate of sarcopenia increased (from 42.2 to 54.3 per cent; P < 0.001). A skeletal muscle index decrease greater than 5 per cent was not associated with an increased risk of total postoperative complications (odds ratio 0.91, 95 per cent c.i. 0.52 to 1.59; P = 0.736) or severe complications (odds ratio 0.66, 0.29 to 1.53; P = 0.329). Conclusion: Skeletal muscle index decreased during neoadjuvant therapy but was not associated with postoperative complications.